Health economics in the treatment of idiopathic menorrhagia
Mirena offers potential cost-benefits compared with hysterectomy in the treatment of menorrhagia. In a randomized comparison of Mirena and hysterectomy by Hurskainen et al.1, total costs arising from healthcare and productivity losses were about 3-fold lower with Mirena than after hysterectomy over a 12-month period (Figure 12)1. Although a proportion of women assigned to the Mirena group eventually proceeded to hysterectomy, the discounted direct and indirect costs in the Mirena group remained approximately 40% lower (US $ 2817 vs. US $ 4660). Overall, Mirena provides patients with an effective option for the treatment of menorrhagia, with avoidance of the risks associated with a surgical procedure and without permanent loss of fertility2.
In another study by You et al.3 over a 5-year time period, Mirena was shown to be less costly and more effective than oral medication for the treatment of menorrhagia in patients who prefer a non-surgical option (i.e. hysterectomy or endometrial resection/ablation). Thus, although cost of oral therapy was only a sixth of that of Mirena, the total medical costs were 20% higher, probably reflecting greater need for extra surgery.
Figure 12: Total costs associated with the treatment of menorrhagia with Mirena or hysterectomy per patient over 12 months of follow-up1.