Cost Effectiveness of Hormone Replacement Therapy in French Postmenopausal Women
The beneficial effects of hormone replacement therapy (HRT) in preventing osteoporosis and, reportedly, ischemic heart disease gives support to its extension to symptom-free women. The purpose of our study is a reevaluation of the risks, benefits, and costs of HRT primary prevention in the French context. In addition to the methodology of benefit analysis, we used two methodological tools, Markovian cohort simulations and meta-analyses. We took into account potential long-term effects, and particularly possible increase in breast cancer risk. The life expectancy gain was evaluated to 0.16 year for a 10-year HRT duration, and the discounted cost/year gained from HRT is FF 143,000 (US $28,600). Our study led to an intermediate cost effectiveness ratio as compared with other accepted health care interventions. However, prevention might be cost effectiveness in specific subpopulations. The study underlines the lack of data about the net effect of combined HRT and the persistence of the effect of HRT after discontinuation.
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