An economic comparison of female sterilization of hysteroscopic tubal occlusion with laparoscopic bilateral tubal ligation

Background: This study compares the expected 5-year costs for permanent sterilization in women between nonincisional hysteroscopic tubal occlusion with the Essure® system performed in an office setting and laparoscopic bilateral tubal ligation (LBTL). Study Design: An economic decision tree is used to predict outcomes and costs to compare these two procedures from a US Medicaid perspective over a 5-year time horizon. Results: Expected costs are $2367 for Essure® and $3545 for LBTL (Essure® saves $1178 or 33% of LBTL costs). Sensitivity analyses show Essure® has lower expected costs across all values considered. If the cost for a LBTL procedure were to decrease by 20% and the cost for Essure® to increase by 20%, Essure® would have still have lower expected costs. Conclusion: Office-based sterilization for women using Essure® can lead to substantial cost savings over 5 years compared to LBTL. This conclusion is robust to varying analytic inputs.