ArticleAnnals of internal medicine2014
Economic return from the Women's Health Initiative estrogen plus progestin clinical trial: a modeling study.
Article in Annals of internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Assessing value in health care: using an interpretive classification system to understand existing practices based on a systematic review.BMC health services research · 2019Pooled it
- Off-label policy through the lens of trazodone usage and spending in the United States.Health affairs scholar · 2025Article
- Advancing Principled Pharmacoepidemiologic Research to Support Regulatory and Healthcare Decision Making: The Era of Real-World Evidence.Clinical pharmacology and therapeutics · 2025Review
- Commentary on the Women's Health Initiative: Over 30 Years of Contribution to Nutrition and Dietetics.Journal of the Academy of Nutrition and Dietetics · 2024Article
- Diet and Chronic Disease Research in the Women's Health Initiative.Journal of the Academy of Nutrition and Dietetics · 2024Review
- Long-term breast cancer incidence trends by mammography, obesity, and menopausal hormone therapy.Breast cancer research and treatment · 2024Observational
- Breast Cancer Prevention: Time for Change.JCO oncology practice · 2021Article
- The Scientific and Cultural Journey to Ovarian Rejuvenation: Background, Barriers, and Beyond the Biological Clock.Medicines (Basel, Switzerland) · 2021Article
- Hormones and thrombosis: risk across the reproductive years and beyond.Translational research : the journal of laboratory and clinical medicine · 2020Review
- Therapeutic effect of Aegle marmelos fruit extract against DMBA induced breast cancer in rats.Scientific reports · 2020Article
- Dual-Outcome Intention-to-Treat Analyses in the Women's Health Initiative Randomized Controlled Hormone Therapy Trials.American journal of epidemiology · 2020Article
- Article
- The Women's Health Initiative Estrogen-alone Trial had differential disease and medical expenditure consequences across age groups.Menopause (New York, N.Y.) · 2020Article
- How can clinical researchers quantify the value of their proposed comparative research?American heart journal · 2019Article
- Using Medicare Claims to Examine Long-term Prostate Cancer Risk of Finasteride in the Prostate Cancer Prevention Trial.Journal of the National Cancer Institute · 2018Article
- Working Together to Address Women's Health in Research and Drug Development: Summary of the 2017 Women's Health Congress Preconference Symposium.Journal of women's health (2002) · 2018Article
- Impact of hormone therapy on Medicare spending in the Women's Health Initiative randomized clinical trials.American heart journal · 2018Article
- Impact of National Heart, Lung, and Blood Institute-Supported Cardiovascular Epidemiology Research, 1998 to 2012.Circulation · 2015Article
- Prioritizing HIV comparative effectiveness trials based on value of information: generic versus brand-name ART in the US.HIV clinical trials · 2015Article
- Exceptional opportunities in medical science: a view from the National Institutes of Health.JAMA · 2015Article
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Authors and funding
11 authors.
Funding
Abstract
backgroundThe findings of the Women's Health Initiative (WHI) estrogen plus progestin (E+P) trial led to a substantial reduction in use of combined hormone therapy (cHT) among postmenopausal women in the United States. The economic effect of this shift has not been evaluated relative to the trial's $260 million cost (2012 U.S. dollars).
objectiveTo estimate the economic return from the WHI E+P trial.
designDecision model to simulate health outcomes for a "WHI scenario" with observed cHT use and a "no-WHI scenario" with cHT use extrapolated from the pretrial period. DATA SOURCES: Primary analyses of WHI outcomes, peer-reviewed literature, and government sources. TARGET POPULATION: Postmenopausal women in the United States, aged 50 to 79 years, who did not have a hysterectomy. TIME HORIZON: 2003 to 2012. PERSPECTIVE: Payer.
interventionCombined hormone therapy. OUTCOME MEASURES: Disease incidence, expenditure, quality-adjusted life-years, and net economic return. RESULTS OF BASE-CASE ANALYSIS: The WHI scenario resulted in 4.3 million fewer cHT users, 126,000 fewer breast cancer cases, 76,000 fewer cardiovascular disease cases, 263,000 more fractures, 145,000 more quality-adjusted life-years, and expenditure savings of $35.2 billion. The corresponding net economic return of the trial was $37.1 billion ($140 per dollar invested in the trial) at a willingness-to-pay level of $100,000 per quality-adjusted life-year. RESULTS OF SENSITIVITY ANALYSIS: The 95% CI for the net economic return of the trial was $23.1 to $51.2 billion. LIMITATION: No evaluation of indirect costs or outcomes beyond 2012.
conclusionThe WHI E+P trial made high-value use of public funds with a substantial return on investment. These results can contribute to discussions about the role of public funding for large, prospective trials with high potential for public health effects. PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.