[Socioeconomic stakes of menopause: evaluation of the cost-effectiveness studies]

Abstract

The extension of hormonal replacement therapy to all women after their menopause as a preventive action is becoming a major public health issue. Cost-effectiveness analysis represents an appropriate tool to address the economical aspects of this issue. Out of the 3 studies reported in the past recent years on this topic, the Oxford Hormone Therapy Group study is the only one to take into account all possible outcomes of the hormonal replacement therapy. Its conclusions, however, cannot be extended directly to other countries, as the hormonal replacement therapy may differ in many aspects, like: 1) the chemical nature, metabolism and mode of administration of the hormones used, both as regard the oestrogen component and the progestative one; 2) the acceptability of the therapy in relation to its side effects; 3) the age-specific morbi-mortality data in relation to hip fractures, breast cancer and cardiovascular diseases.