Skip to main content

Research Repository

Advanced Search

Exploring the use of cost-benefit analysis to compare pharmaceutical treatments for menorrhagia

Sanghera, Sabina; Frew, Emma; Gupta, Janesh Kumar; Kai, Joe; Roberts, Tracy Elizabeth

Exploring the use of cost-benefit analysis to compare pharmaceutical treatments for menorrhagia Thumbnail


Sabina Sanghera

Emma Frew

Janesh Kumar Gupta

Tracy Elizabeth Roberts


Background: The extra-welfarist theoretical framework tends to focus on health-related quality of life, whilst the welfarist framework captures a wider notion of well-being. EQ-5D and SF-6D are commonly used to value outcomes in chronic conditions with episodic symptoms, such as heavy menstrual bleeding (clinically termed menorrhagia). Because of their narrow-health focus and the condition’s periodic nature these measures may be unsuitable. A viable alternative measure is willingness to pay (WTP) from the welfarist framework.

Objective: We explore the use of WTP in a preliminary cost-benefit analysis comparing pharmaceutical treatments for menorrhagia.

Methods: A cost-benefit analysis was carried out based on an outcome of WTP. The analysis is based in the UK primary care setting over a 24-month time period, with a partial societal perspective. Ninety-nine women completed a WTP exercise from the ex-ante (pre-treatment/condition) perspective. Maximum average WTP values were elicited for two pharmaceutical treatments, levonorgestrel-releasing intrauterine system (LNG-IUS) and oral treatment. Cost data were offset against WTP and the net present value derived for treatment. Qualitative information explaining the WTP values was also collected.

Results: Oral treatment was indicated to be the most cost-beneficial intervention costing £107 less than LNG-IUS and generating £7 more benefits. The mean incremental net present value for oral treatment compared with LNG-IUS was £113. The use of the WTP approach was acceptable as very few protests and non-responses were observed.

Conclusion: The preliminary cost-benefit analysis results recommend oral treatment as the first-line treatment for menorrhagia. The WTP approach is a feasible alternative to the conventional EQ-5D/SF-6D approaches and offers advantages by capturing benefits beyond health, which is particularly relevant in menorrhagia.


Sanghera, S., Frew, E., Gupta, J. K., Kai, J., & Roberts, T. E. (2015). Exploring the use of cost-benefit analysis to compare pharmaceutical treatments for menorrhagia. PharmacoEconomics, 33(9),

Journal Article Type Article
Acceptance Date Apr 1, 2015
Online Publication Date Apr 25, 2015
Publication Date Sep 1, 2015
Deposit Date Oct 27, 2017
Publicly Available Date Oct 27, 2017
Journal PharmacoEconomics
Print ISSN 1170-7690
Electronic ISSN 1179-2027
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 33
Issue 9
Keywords Cost-Benefit Analysis; Pharmaceutical Treatments;
Menorrhagia; Primary Care.
Public URL
Publisher URL
Related Public URLs


You might also like

Downloadable Citations