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Economic impact of Tibolone compared with Continuous-Combined Hormone Replacement Therapy in the management of climacteric symptoms in postmenopausal women.
Maturitas. 2007 Oct 20; 58(2):138-49.M

Abstract

BACKGROUND

Deciding whether to treat postmenopausal women suffering from climacteric symptoms with Continuous Combined Hormone Replacement Therapy (CCHRT) has become increasingly difficult after the release of the Women's Health Initiative results. As a result, development of alternatives to CCHRT is required. Tibolone, which is a synthetic steroid that has estrogenic, progestogenic and androgenic properties, is reported to be a promising alternative. It has been used in Europe, in the same indication as CCHRT, for approximately 20 years but is not yet available in Canada.

OBJECTIVE

We carried out a cost-utility analysis comparing a 3-year-treatment course with Tibolone 2.5mg and conjugated equine estrogens (CEE)/medroxyprogesterone acetate (MPA) (0.625 mg/2.5 mg) in the management of postmenopausal women with climacteric symptoms.

METHODS

A Markov model, considering persistence, vaginal bleeding and climacteric symptoms, was elaborated to compare the different options in terms of cost and Quality Adjusted Life Years (QALYs), according to a public third-party payer perspective.

RESULTS

Compared with CEE/MPA, Tibolone led to an increase in cost (dollars 485 for Tibolone versus dollars 232 for CEE/MPA) and a slight increase in QALYs (2.08 for Tibolone versus 2.05 for CEE/MPA). Consequently, the incremental cost per QALY gained ratio was dollars 9198.

CONCLUSION

According to the results, Tibolone seems to be a cost-effective alternative to CEE/MPA. However, those results should be interpreted with caution insofar as the difference in terms of QALY is clinically difficult to value and taking into account the limited data on Tibolone's long-term innocuity.

Authors+Show Affiliations

Faculty of Pharmacy, University of Montreal, Centre-ville, Montreal, QC H3C 3J7, Canada. vakaramoko.diaby@umontreal.caNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17870259

Citation

Diaby, Vakaramoko, et al. "Economic Impact of Tibolone Compared With Continuous-Combined Hormone Replacement Therapy in the Management of Climacteric Symptoms in Postmenopausal Women." Maturitas, vol. 58, no. 2, 2007, pp. 138-49.
Diaby V, Perreault S, Lachaine J. Economic impact of Tibolone compared with Continuous-Combined Hormone Replacement Therapy in the management of climacteric symptoms in postmenopausal women. Maturitas. 2007;58(2):138-49.
Diaby, V., Perreault, S., & Lachaine, J. (2007). Economic impact of Tibolone compared with Continuous-Combined Hormone Replacement Therapy in the management of climacteric symptoms in postmenopausal women. Maturitas, 58(2), 138-49.
Diaby V, Perreault S, Lachaine J. Economic Impact of Tibolone Compared With Continuous-Combined Hormone Replacement Therapy in the Management of Climacteric Symptoms in Postmenopausal Women. Maturitas. 2007 Oct 20;58(2):138-49. PubMed PMID: 17870259.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Economic impact of Tibolone compared with Continuous-Combined Hormone Replacement Therapy in the management of climacteric symptoms in postmenopausal women. AU - Diaby,Vakaramoko, AU - Perreault,Sylvie, AU - Lachaine,Jean, Y1 - 2007/09/17/ PY - 2007/03/22/received PY - 2007/07/11/revised PY - 2007/07/14/accepted PY - 2007/9/18/pubmed PY - 2008/1/16/medline PY - 2007/9/18/entrez SP - 138 EP - 49 JF - Maturitas JO - Maturitas VL - 58 IS - 2 N2 - BACKGROUND: Deciding whether to treat postmenopausal women suffering from climacteric symptoms with Continuous Combined Hormone Replacement Therapy (CCHRT) has become increasingly difficult after the release of the Women's Health Initiative results. As a result, development of alternatives to CCHRT is required. Tibolone, which is a synthetic steroid that has estrogenic, progestogenic and androgenic properties, is reported to be a promising alternative. It has been used in Europe, in the same indication as CCHRT, for approximately 20 years but is not yet available in Canada. OBJECTIVE: We carried out a cost-utility analysis comparing a 3-year-treatment course with Tibolone 2.5mg and conjugated equine estrogens (CEE)/medroxyprogesterone acetate (MPA) (0.625 mg/2.5 mg) in the management of postmenopausal women with climacteric symptoms. METHODS: A Markov model, considering persistence, vaginal bleeding and climacteric symptoms, was elaborated to compare the different options in terms of cost and Quality Adjusted Life Years (QALYs), according to a public third-party payer perspective. RESULTS: Compared with CEE/MPA, Tibolone led to an increase in cost (dollars 485 for Tibolone versus dollars 232 for CEE/MPA) and a slight increase in QALYs (2.08 for Tibolone versus 2.05 for CEE/MPA). Consequently, the incremental cost per QALY gained ratio was dollars 9198. CONCLUSION: According to the results, Tibolone seems to be a cost-effective alternative to CEE/MPA. However, those results should be interpreted with caution insofar as the difference in terms of QALY is clinically difficult to value and taking into account the limited data on Tibolone's long-term innocuity. SN - 0378-5122 UR - https://www.unboundmedicine.com/medline/citation/17870259/Economic_impact_of_Tibolone_compared_with_Continuous_Combined_Hormone_Replacement_Therapy_in_the_management_of_climacteric_symptoms_in_postmenopausal_women_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0378-5122(07)00220-4 DB - PRIME DP - Unbound Medicine ER -