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Related Experiment Videos

Hormone replacement therapy in a risk-benefit perspective

E Daly1, M P Vessey, D Barlow

  • 1Department of Public Health and Primary Care, University of Oxford, Radcliffe Infirmary, UK.

Maturitas
|March 1, 1996
PubMed
Summary

Hormone replacement therapy (HRT) is cost-effective for symptomatic menopausal women. Long-term HRT for hysterectomised women may be cost-effective if oestrogen protects against cardiovascular disease.

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Area of Science:

  • Health Economics
  • Pharmacoeconomics
  • Endocrinology

Background:

  • Hormone replacement therapy (HRT) is used for menopausal symptoms and prophylaxis.
  • The cost-effectiveness of different HRT strategies requires evaluation, especially concerning cardiovascular disease and breast cancer risks.

Purpose of the Study:

  • To assess the relative cost-effectiveness of various hormone replacement therapy (HRT) treatment strategies.
  • To evaluate the economic impact of HRT on the National Health Service (NHS).

Main Methods:

  • A computer model was utilized to assess cost-effectiveness.
  • Sensitivity analyses were conducted to evaluate the impact of assumptions regarding HRT effects, particularly on cardiovascular disease.

Main Results:

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  • Net NHS expenditure is critically dependent on direct treatment costs, not indirect costs from side-effects.
  • Reduced cardiovascular disease risk significantly impacts mortality, outweighing potential small increases in breast cancer risk.
  • Long-term prophylactic HRT for hysterectomised women appears cost-effective if oestrogen offers cardioprotection.
  • Treating symptomatic menopausal women with HRT offers excellent value for money.

Conclusions:

  • The cost-effectiveness of HRT is influenced by direct treatment costs and potential cardiovascular benefits.
  • HRT for symptomatic menopausal women is highly cost-effective.
  • Uncertainty regarding combined oestrogen-progestogen therapy and cardioprotection limits conclusions for prophylactic treatment in non-hysterectomised asymptomatic women.