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 Cost Comparison of Fibroid Treatment

When we consider the cost of a treatment we must look at the cost to the NHS in the short and longer term, the cost to the patients and their families, who may have to take time off work to look the woman and the costs to employers and society. It is important to people that they recover quickly and get back to normal life as soon as possible. Most women cannot afford to take 3 months off work, especially if they run their own business, have a senior position, are on piece work or have family responsibilities. NICE has not considered the costs to patients, their families and society in the past.

The NHS has a tariff which is an average cost of treatment in England. The table below shows the current tariff and there are considerable savings to be made for the NHS.

Each year the NHS introduces new NHS Tariffs, which are the average cost of a procedure across the NHS in England.  The Tariff costs below are for financial year 17/18  The Department of Health wants to encourage less hysterectomies and more less invasive treatments such as UFE.

Cost Comparisons
Procedure Hysterectomy Myomectomy Embolisation
NHS Tariff 17-18

£3,275

£2,609

£2,400

Cost Saving Comparison with UAE/UFE per procedure

£875

£209

 

 

In the table below we show how much the NHS could save if all the 60% of hysterectomies performed for fiobroids in England each year were converted to UFE. FEmISA does not advocate this as all women should have a choice in treatment, but most do not as they are not told of alternatives to hysterectomy.

 

Here is an analysis for England as a whole, on the savings that could be made if women had fully informed choice of their treatment options from a multi-disciplinary fibroid outpatients’ clinic run by interventional radiologists and gynaecologist working together for the benefit of women with fibroids.  There are few of these clinics in the country, but one is at Heartlands Hospital in Birmingham.  Here 60% of women with fibroids opt for UFE.  This is a benchmark for the rest of the UK.

 

Potential Saving on In-Patient Costs from Treatments with Embolisation instead of Hysterectomy

 

Savings Under Current 17-18 NHSTariff

Total number of Hysterectomies in England in the NHS

               31,624

60% for fibroids

               18.974

In-patient cost of Hysterectomy (MA07E-F £3,275- 4,259) using lower tariff

£     103,568,600

If 60% of hysterectomies for fibroids were treated by UFE - costs

£       27,323,136

(60% e.g.   Heart of England)(YR54Z UFE £2,400)

Potential   Cost saving by treating 60% with embolisation

£       51,389,000

Number   of potential bed days saved

             139,145

Further potential cost savings

  • Reduction in HRT usage from early menopause associated with hysterectomy
  • Reduction in short and longer term readmissions and morbidity

It is also important to look at some of the costs to patients and their families and employers.

Reduction in cost of patients and their families

  • Less need for care at home from family member
  • Return to work/normal life 1-2 weeks with embolisation c.f. Hysterectomy 10 weeks
  • Early HRT use much less likely - prescription charges per hormone so at least double normal charge
  • Reduction in cost to the economy, employers, society

 

Reduction in Cost to the Economy, Employers and Society

Return to work/normal life 1-2   weeks with embolisation c.f. Hysterectomy 10 weeks

2 weeks off work versus 10 weeks - working days saved

           151,795

Average weekly earnings May '17[Office for National Statistics]

£           503.00

Potential   economic saving from earlier return to work from UFE

£ 76,352,986

 

 Estimated Full Annual Costs of Fibroids in USA

 

A clinical study from USA on the total costs   of fibroids to the healthcare system and to the economy as a whole has been   publishedrecently. [The estimated annual cost of uterine leiomyomata in the   United States. Am J Obstet Cardozo ER,   Clark AD, Banks NK, Henne MB, Stegmann BJ, Segars JH - Am J Obstet Gynecol.   2012 Mar;206(3):211.e1-9. Epub 2011 Dec 11]

Estimated   annual direct costs (surgery, hospital admissions,

$4.1-9.4 billion

outpatient visits, and   medications)

Estimated   lost work-hour costs - annually

$1.55-17.2 billion

Obstetric   outcomes that were attributed to fibroids

$238m -   $7.76 bn

Total   costs attributed to fibroids annually

$5.9-34.4   billion