The COMPARE Study: Facility Costs Associated With Hysterectomy, Myomectomy, and the Sonata Procedure for Treatment of Uterine Fibroids

Purpose: The COMPARE study examined facility costs of sonographyguided transcervical fibroid ablation (TFA) using the Sonata System, hysterectomy, and myomectomy for the treatment of symptomatic uterine fibroids. Design and methodology: A facility-perspective cost analysis of hos- pital charge data in the perioperative and the 30-day postoperative period was conducted. Length of stay (LOS) and charge data for the TFA arm were collected in the SONATA trial. Hospital-specific cost-to-charge ratios (CCRs) were used to convert charges to facility costs. Charge data and LOS for comparator arms were collected retrospectively from the IBM MarketScan Commercial Database and converted to costs using Medicare national average CCRs. Results: TFA patients had a statistically significant shorter mean LOS (5.1 hours) compared with hysterectomy (73 hours) or myomectomy (80 hours; all P<.001) patients. The mean facility cost of TFA was $7,701, lower than the $10,353 for hysterectomy and the $12,003 for myomectomy (all P<.001). TFA facility costs were also statistically significantly lower across all stratifications (P<.01) compared with hysterectomy and myomectomy subgroups for site of service (inpatient or outpatient), and/or use of robotic assistance. The lower facility costs were preserved in follow-up analyses that included route subtypes (e.g., laparoscopic, open, vaginal) and removal of high-cost outliers from comparator arms. Conclusion: TFA using the Sonata System had a shorter LOS than either comparator arms regardless of the procedure route. Sonata was also associated with considerably lower facility costs compared with either hysterectomy or myomectomy regardless of procedure route, site of service, or use of robotic assistance.