MRI-Guided Focused Ultrasound for Uterine Fibroid Treatment

In the article by Kong et al published at the AJR they report on the cost effectiveness of MR-guided focused ultrasound in the treatment of symptomatic uterine fibroids.  They compared this novel treatment with more accepted therapies such as uterine artery embolization (UAE) and hysterectomy.

In their base-case analysis, UAE as a first-line treatment of symptomatic fibroids was the most effective and expensive strategy (22.75 QALYs; $22,968), followed by MRI-guided focused ultrasound (22.73 QALYs; $20,252) and hysterectomy (22.54 QALYs; $11,253). MRI-guided focused ultrasound was cost effective relative to hysterectomy, with an associated incremental cost-effectiveness ratio (ICER) of $47,891/QALY. The ICER of UAE relative to MRI-guided focused ultrasound was $234,565/QALY, exceeding the WTP threshold of $50,000/QALY, therefore rendering MRI-guided focused ultrasound also cost effective relative to UAE.

The authors concluded that MRI-guided focused ultra-sound, an outpatient procedure, with a cost of approximately $20,000 per treatment is a cost-effective noninvasive therapy. For those not eligible for MRI-guided focused ultra-sound, UAE remains a cost-effective option.  Their recommendations took into account short and long-term changes in probabilities of recurrence, symptom relief and quality of life associated with the studied treatments.