Cost-effectiveness of the recommended medical intervention for the treatment of dysmenorrhea and endometriosis in Japan

Abstract

Background and objectiveThis study aims to assess the cost-effectiveness of early physician consultation and guideline-based intervention to prevent endometriosis and/or disease progression using oral contraceptive (OC) and progestin compared to follow-up of self-care for dysmenorrhea in Japan.MethodsA yearly-transmitted Markov model of five major health states with four sub-medical states was constructed. Transition probabilities among health and medical states were derived from Japanese epidemiological patient surveys and converted to appropriate parameters for inputting into the model. The dysmenorrhea and endometriosis-associated direct costs included inpatient, outpatient visit, surgery, and medication (OC agents, over-the-counter drugs), etc. The utility measure for patients with phase I–IV endometriosis comprised a visual analogue scale. We estimated the cost per quality-adjusted life year (QALY) at a time horizon of 23 years. An annual discount rate at 3% for both cost and outcome was considered.ResultsThe base case outcomes indicated that the intervention would be more cost-effective than self-care, as the incremental cost-effectiveness ratio (ICER) yielded 115,000 JPY per QALY gained from the healthcare payers’ perspective and the societal monetary value (SMV) was approximately positive 3,130,000 JPY, favoring the intervention in the cost–benefit estimate. A tornado diagram depicting the stochastic sensitivity analysis of the ICER and SMV from both the healthcare payers’ and societal perspectives confirmed the robustness of the base case. A probabilistic analysis resulting from 10,000-time Monte Carlo simulations demonstrated efficiency at willingness-to-pay thresholds in more than 90% of the iterations.ConclusionsThe present analysis demonstrated that early physician consultation and guideline-based intervention would be more cost-effective than self-care in preventing endometriosis and/or disease progression for patients with dysmenorrhea in Japan.

Living with Restrictions. The Perspective of Nursing Students with Primary Dysmenorrhea

“…We believe that consulting a health care professional to evaluate alternative treatments could help avoid women having to abandon sports activities. Seeking professional care for the treatment of PD is considered a cost-effective management strategy [48]. However, this is an infrequent solution among young people.…”

Why Do Some Spanish Nursing Students with Menstrual Pain Fail to Consult Healthcare Professionals?

“…An early medical consultation reduces complications. For example, in the case of secondary dysmenorrhea produced by endometriosis, early diagnosis is considered essential to reduce the physical, emotional and social side-effects of this condition [17,18].…”

“…Furthermore, dysmenorrhea has been related to psychological disorders such as stress, anxiety and depression, and therefore the performance of a psychological assessment before choosing therapeutic methods may be necessary [24]. In addition, there is evidence that early medical assessment is more cost-effective than self-care in cases of dysmenorrhea [17]. Along these lines, the Spanish Society of Gynecology and Obstetrics (SEGO) advises young women to consult a health professional when faced with menstrual pain.…”

“…Several studies to date have examined the management of menstrual pain and problems surrounding self-medication, primarily among young women [2,17,34]. However, a knowledge gap exists in Spain regarding why women from different regions fail to consult health professionals for these issues.…”

Getting Rid of “Bomb Pushing the Womb”: Dysmenorrhea Management-Mini Review

“…In the Western populations, endometriosis is estimated to occur in 5% to 10% of the population; however, the prevalence of endometriosis is suspected to be higher in Asian women, affecting approximately 15% of women [9]. The estimated health care expenditures for endometriosis at nearly $70 billion per year in the United States, $7.4 billion in Australia, approximately 380 billion JPY Japan [10][11][12]. Heavy menstrual bleeding (HMB) is the second highest-ranked reason for a hospital referral and accounts for 12% of all gynecologic referrals [13].…”