{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T19:43:43Z","timestamp":1777837423283,"version":"3.51.4"},"reference-count":26,"publisher":"BMJ","issue":"9","funder":[{"DOI":"10.13039\/501100003358","name":"Gedeon Richter","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003358","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,5,5]]},"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess the budget impact of using ulipristal acetate (UPA) 5 mg to treat women with uterine fibroids (UF) causing moderate to severe symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>We modelled trends in the number of surgical procedures for symptomatic UF, with and without the use of UPA for preoperative or intermittent treatment and assessed the budget impact of UPA use from the French national healthcare insurance system perspective.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>A French national hospital database (PMSI) that records admissions and relative procedures to public and private hospitals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Women eligible for surgical procedures for uterine fibroids.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Economic impact of UPA treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>This study based on observational retrospective data shows that the current use of UPA in its preoperative indication was associated with 5645 fewer surgeries from 2013 to 2015. Extrapolation suggests 17 885 fewer surgeries from 2016 to 2019. Overall, preoperative use of UPA results in substantial cost savings for the French national healthcare insurance system, with a cumulated budget impact estimated at \u20ac\u22125 million from 2013 to 2015 and \u20ac\u221213.5 million from 2016 to 2019. In addition, treating women nearing the menopause (\u226548 years old) with intermittent treatment from 2017 to 2019 could produce an incremental cost saving of \u20ac19 million.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study shows that the use of UPA in women eligible for surgical procedures for UF is associated with considerable savings for the French national healthcare insurance system in both preoperative and intermittent indications by decreasing the need to perform surgeries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-015571","type":"journal-article","created":{"date-parts":[[2017,9,4]],"date-time":"2017-09-04T20:10:13Z","timestamp":1504555813000},"page":"e015571","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Economic impact of ulipristal acetate on surgical procedures for uterine fibroids in France"],"prefix":"10.1136","volume":"7","author":[{"given":"Herv\u00e9","family":"Fernandez","sequence":"first","affiliation":[{"name":"Gynecology obstetric, AP-HP, H\u00f4pital Bic\u00eatre, Service de Gyn\u00e9cologie Obst\u00e9trique, 78 rue du G\u00e9n\u00e9ral Leclerc, Le Kremlin Bic\u00eatre, France"},{"name":"Universit\u00e9 Paris-Saclay, 63 rue Gabriel P\u00e9ri, Le Kremlin Bic\u00eatre, France"},{"name":"INSERM U1018 CESP, Reproduction et d\u00e9veloppement de l\u2019enfant, 82 rue du G\u00e9n\u00e9ral Leclerc, Le Kremlin Bic\u00eatre, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Jourdain","sequence":"additional","affiliation":[{"name":"Clinique Jean Villar, Bordeaux-Bruges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Villefranque","sequence":"additional","affiliation":[{"name":"Maternit\u00e9, H\u00f4pital Simone Veil, 14 rue de Saint Prix, Eaubonne, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthieu","family":"Lehmann","sequence":"additional","affiliation":[{"name":"PregLem SA, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Lafuma","sequence":"additional","affiliation":[{"name":"Cemka-Eval,boulevard Mar\u00e9chal-Joffre, Bourg-la-Reine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthieu","family":"Trancart","sequence":"additional","affiliation":[{"name":"Cemka-Eval,boulevard Mar\u00e9chal-Joffre, Bourg-la-Reine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,9,3]]},"reference":[{"key":"2025101812003043000_7.9.e015571.1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S51083"},{"key":"2025101812003043000_7.9.e015571.2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1742-4755-11-10","article-title":"Uterine leiomyoma: understanding the impact of symptoms on womens' lives","volume":"11","author":"Brito","year":"2014","journal-title":"Reprod Health"},{"key":"2025101812003043000_7.9.e015571.3","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6874-12-6","article-title":"Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women","volume":"12","author":"Zimmermann","year":"2012","journal-title":"BMC Womens Health"},{"key":"2025101812003043000_7.9.e015571.4","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.jgyn.2014.07.006","article-title":"[Prevalence of uterine fibroids in France and impact on quality of life: results of a survey among 2500 women between 30-55 years]","volume":"43","author":"Fernandez","year":"2014","journal-title":"J Gynecol Obstet Biol Reprod"},{"key":"2025101812003043000_7.9.e015571.5","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000136079.62513.39"},{"key":"2025101812003043000_7.9.e015571.6","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1517\/17460441.2011.602670","article-title":"Lessons learned from the preclinical drug discovery of asoprisnil and ulipristal for non-surgical treatment of uterine leiomyomas","volume":"6","author":"Maruo","year":"2011","journal-title":"Expert Opin Drug Discov"},{"key":"2025101812003043000_7.9.e015571.7","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmt042"},{"key":"2025101812003043000_7.9.e015571.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103182"},{"key":"2025101812003043000_7.9.e015571.9","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1056\/NEJMoa1103180","article-title":"Ulipristal acetate versus Leuprolide Acetate for uterine fibroids","volume":"366","author":"Donnez","year":"2012","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025101812003043000_7.9.e015571.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.09.032"},{"key":"2025101812003043000_7.9.e015571.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2014.02.008"},{"key":"2025101812003043000_7.9.e015571.12","unstructured":"European Medicine Agency http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/EPAR_-_Public_assessment_report\/human\/002041\/WC500124088.pdf"},{"key":"2025101812003043000_7.9.e015571.13","unstructured":"Arr\u00eat\u00e9 du 22 juillet 2013 modifiant la liste des sp\u00e9cialit\u00e9s pharmaceutiques remboursables aux assur\u00e9s sociaux. https:\/\/www.legifrance.gouv.fr\/affichTexte.do;jsessionid=AB89B8DE6FBB9762448BA5540B4EEE7C.tpdila14v_1?cidTexte=JORFTEXT000027748918&dateTexte=&oldAction=rechJO&categorieLien=id&idJO=JORFCONT000027748776"},{"key":"2025101812003043000_7.9.e015571.14","unstructured":"Commission De La Transparence http:\/\/www.has-sante.fr\/portail\/upload\/docs\/application\/pdf\/2012-09\/esmya_18072012_avis__ct12237.pdf"},{"key":"2025101812003043000_7.9.e015571.15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103180"},{"key":"2025101812003043000_7.9.e015571.16","unstructured":"European Medicine Agency http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/EPAR_-_Assessment_Report_-_Variation\/human\/002041\/WC500189366.pdf"},{"key":"2025101812003043000_7.9.e015571.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2013.08.2291"},{"key":"2025101812003043000_7.9.e015571.18","unstructured":"Data extracted from the exhaustive drug reimbursement claims (Medic\u2019AM) provided by the French national healthcare insurance system. http:\/\/www.ameli.fr\/l-assurance-maladie\/statistiques-et-publications\/donnees-statistiques\/medicament\/medic-am\/medic-am-mensuel-2016.php"},{"key":"2025101812003043000_7.9.e015571.19","unstructured":"Rapport Traitement hormonal substitutif de la m\u00e9nopause. Anaes (HAS) \/ Afssaps, argumentaire mai 2004."},{"key":"2025101812003043000_7.9.e015571.20","unstructured":"MCO and HAD rates. http:\/\/www.atih.sante.fr\/tarifs-mco-et-had"},{"key":"2025101812003043000_7.9.e015571.21","unstructured":"CCAM Online. http:\/\/www.ameli.fr\/accueil-de-la-ccam\/index.php"},{"key":"2025101812003043000_7.9.e015571.22","unstructured":"National Cost Studies - Presentation and recruitment. http:\/\/www.atih.sante.fr\/information-sur-les-couts\/etudes-nationales-de-couts-presentation-et-recrutement"},{"key":"2025101812003043000_7.9.e015571.23","unstructured":"Open Damir: comprehensive database on interregional health insurance expenditure. http:\/\/open-data-assurance-maladie.ameli.fr\/depenses\/index.php"},{"key":"2025101812003043000_7.9.e015571.24","unstructured":"Hyst\u00e9rectomie. http:\/\/www.ameli.fr\/fileadmin\/user_upload\/documents\/memo_AT_hysterectomie_BD.pdf"},{"key":"2025101812003043000_7.9.e015571.25","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.ejogrb.2016.11.003","article-title":"Real world data of 1473 patients treated with ulipristal acetate for uterine fibroids: premya study results","volume":"208","author":"Fernandez","year":"2017","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025101812003043000_7.9.e015571.26","first-page":"15","article-title":"Repeated-intermittent use of ulipristal acetate for the management of uterine fibroids: an italian pharmacoeconomic evaluation","volume":"68","author":"Maratea","year":"2016","journal-title":"Minerva Ginecol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-015571","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T19:00:40Z","timestamp":1760814040000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-015571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9]]},"references-count":26,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2017,9,3]]},"published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1136\/bmjopen-2016-015571"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-015571","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9]]}}}