Weinstein M C, Schiff I
Obstet Gynecol Surv. 1983 Aug;38(8):445-55. doi: 10.1097/00006254-198308000-00001.
Costs, risks, and benefits of estrogen-progestin therapy in the menopause were compared with those for estrogen alone, using techniques of cost-effectiveness analysis. With the progestin added, reduced costs of endometrial monitoring and treatment of endometrial lesions more than offset the increased cost of the drug regimen with a net saving of $230-$430 per patient, depending on the duration of treatment. An estimated gain in life expectancy with estrogen-progestin compared to estrogen alone may be partly offset by a perceived reduction in the quality of life owing to the prolongation of menstruation in women receiving progestin. Overall, based on currently available evidence, estrogen-progestin therapy appears to be cost-effective, except in women who consider the adverse effects of continued menstruation to offset the relief of menopausal symptoms. These conclusions must be viewed as tentative, pending further clarification of the roles of estrogens and progestins in cardiovascular disease and breast cancer.
采用成本效益分析技术，对更年期雌激素 - 孕激素疗法与单纯雌激素疗法的成本、风险和益处进行了比较。添加孕激素后，子宫内膜监测和子宫内膜病变治疗成本的降低，超过了药物治疗方案增加的成本，每位患者净节省230 - 430美元，具体金额取决于治疗持续时间。与单纯使用雌激素相比，雌激素 - 孕激素疗法预期寿命的增加，可能会因接受孕激素治疗的女性月经延长导致生活质量下降而部分抵消。总体而言，根据现有证据，雌激素 - 孕激素疗法似乎具有成本效益，但那些认为持续月经的不良反应抵消了更年期症状缓解效果的女性除外。在雌激素和孕激素在心血管疾病和乳腺癌中的作用得到进一步明确之前，这些结论必须视为初步结论。
