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

Abstract

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.

Citation

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), https://doi.org/10.1007/s40273-015-0280-0

• 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
• DOI: https://doi.org/10.1007/s40273-015-0280-0
• Keywords: Cost-Benefit Analysis; Pharmaceutical Treatments; ; Menorrhagia; Primary Care.
• Public URL: https://nottingham-repository.worktribe.com/output/758134
• Publisher URL: https://link.springer.com/article/10.1007%2Fs40273-015-0280-0
• Related Public URLs: http://creativecommons.org/licenses/by-nc/4.0/