A comparison of the cost–utility of ultrasound‐guided high‐intensity focused ultrasound and hysterectomy for adenomyosis: a retrospective study

Objective To evaluate cost-effectiveness of ultrasound-guided high-intensity focused ultrasound (USgHIFU) and open hysterectomy for adenomyosis. Design A retrospective analysis. Setting Gynaecological department in a single centre in China. Population Patients with symptomatic adenomyosis. Main outcome measures Cost difference between patients with adenomyosis treated with USgHIFU and open hysterectomy. Methods Three hundred and sixty-eight patients with adenomyosis were retrospectively reviewed. Among them, 302 patients were treated with USgHIFU and 66 patients with open hysterectomy. All of them had 1-, 3-, 6- and 12-month follow ups. The patients’ quality of life (QOL) was evaluated and the utility scores were obtained from a rating scale to conduct a cost–utility analysis (CUA). Results No significant differences were found at any follow-up time point in the QOL between the two groups (P > 0.05). After treatment, the QOL scores significantly increased in both groups (P < 0.05): the quality adjusted life year (QALY) for patients treated with USgHIFU was USUS$5256.48, whereas it was USUS$7510.03 for patients treated with open hysterectomy. Both incremental cost and sensitivity analysis showed that USgHIFU was less costly than open hysterectomy. Conclusions The QOL of patients with adenomyosis can be significantly improved by either USgHIFU or open hysterectomy, but USgHIFU is less costly. Tweetable abstract USgHIFU can safely be used to treat patients with adenomyosis and significantly improved the quality of life of patients after treatment. The cost of USgHIFU is less than that of surgical treatment.