Cost-effectiveness analysis of the surgical treatment of female urinary incontinence using slings and meshes

Montesino-Semper, M.; Jiménez-Calvo, J.; Cabases, Juan M.; Iriso, Eduardo Sánchez; Hualde-Alfaro, A.; García-García, Diego

doi:10.1016/j.ejogrb.2013.08.035

Cited by 12 publications

(9 citation statements)

References 25 publications

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“…Arlandis-Guzman et al [34] reported QALY gains of 0.01014, 0.00846, and 0.00957, with the antimuscarinic drugs fesoterodine, tolterodine, and solifenacin, respectively. However, second-line treatments with sling surgery could produce larger QALY gains (0.0504) [35]. Nevertheless, although the QALY gains with conservative treatments are low, in sheer numbers, the patient group that can potentially benefit from treatment is large; thus, the attainable total QALY gain is substantial.…”

Section: Discussionmentioning

confidence: 99%

Mobile App for Treatment of Stress Urinary Incontinence: A Cost-Effectiveness Analysis

Sjöström¹,

Lindholm²,

Samuelsson³

2017

J Med Internet Res

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BackgroundMobile apps can increase access to care, facilitate self-management, and improve adherence to treatment. Stress urinary incontinence (SUI) affects 10-35% of women and, currently, an app with instructions for pelvic floor muscle training (PFMT) is available as first-line treatment. A previous randomized controlled study demonstrated that the app benefitted symptom severity and quality of life (QoL); in this study we investigate the cost-effectiveness of the app.ObjectiveThe objective of this study was to evaluate the health economy of the app for treating SUI.MethodsThis deterministic cost-utility analysis, with a 1-year societal perspective, compared the app treatment with no treatment. Health economic data were collected alongside a randomized controlled trial performed in Sweden from March 2013 to October 2014. This study included 123 community-dwelling women participants of 18 years and above, with stress urinary incontinence ≥1 time per week. Participants were self-assessed with validated questionnaires and 2-day leakage diaries, and then randomized to 3 months of treatment (app group, n=62) or no treatment (controls, n=61). The app focused on pelvic floor muscle training, prescribed 3 times daily. We continuously registered treatment delivery costs. Data were collected on each participant’s training time, incontinence aids, and laundry at baseline and at a 3-month follow-up. We measured quality of life with the International Consultation on Incontinence Modular Questionnaire on Lower Urinary Tract Symptoms and Quality of Life, and calculated the quality-adjusted life years (QALYs) gained. Data from the 3-month follow-up were extrapolated to 1 year for the calculations. Our main outcome was the incremental cost-effectiveness ratios compared between app and control groups. One-way and multiway sensitivity analyses were performed.ResultsThe mean age of participants was 44.7 years (SD 9.4). Annual costs were €547.0 for the app group and €482.4 for the control group. Annual gains in quality-adjusted life years for app and control groups were 0.0101 and 0.0016, respectively. Compared with controls, the extra cost per quality-adjusted life year for the app group ranged from −€2425.7 to €14,870.6, which indicated greater gains in quality-adjusted life years at similar or slightly higher cost.ConclusionsThe app for treating stress urinary incontinence is a new, cost-effective, first-line treatment with potential for increasing access to care in a sustainable way for this patient group.

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Section: Discussionmentioning

confidence: 99%

Mobile App for Treatment of Stress Urinary Incontinence: A Cost-Effectiveness Analysis

Sjöström¹,

Lindholm²,

Samuelsson³

2017

J Med Internet Res

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“…In the United States alone, over 94 000 women undergo surgery for UI, and $12.4 billion are spent managing UI annually . Surgery for UI with slings is cost‐effective as compared to abstaining . Even though the cumulative risk for reoperation due to UI is 8.6% (either after a sling or retropubic colposuspension), after transobturator tape (TOT) procedure the median number of pads used per day is significantly reduced compared to baseline .…”

Section: Discussionmentioning

confidence: 99%

“…7,25 Surgery for UI with slings is cost-effective as compared to abstaining. 26 Even though the cumulative risk for reoperation due to UI is 8.6% (either after a sling or retropubic colposuspension), 27 after transobturator tape (TOT) procedure the median number of pads used per day is significantly reduced compared to baseline. 2 Nonetheless, median cure rate after medical interventions for SUI and urgency UI is 82.3% and 49% respectively.…”

Section: Discussionmentioning

confidence: 99%

24/7 usage of continence pads and quality of life impairment in women with urinary incontinence

Grzybowska

Wydra

2018

Int J Clin Pract

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“…Nevertheless, Montesino et al 25 have recently evaluated the efficiency of surgical treatment -with mini-slings or TVT-O, compared to no surgery in a sample of women with stress urinary incontinence, mixed urinary incontinence, and incontinence associated with prolapse. However, as comparison of the evaluated procedures is not the objective of their study, they did not disaggregate the result by type of procedure or incontinence.…”

Section: Discussionmentioning

confidence: 99%

Cost Effectiveness analysis of Surgical Treatment of Stress Urinary Incontinence Using Single-Incision Mini-Slings vs. Tension-Free Vaginal Obturator in Spain

Castañeda¹,

Sanz-Granda²,

Hidalgo³

et al. 2015

Surg Res Open J

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Cost-effectiveness analysis of the surgical treatment of female urinary incontinence using slings and meshes

Cited by 12 publications

References 25 publications

Mobile App for Treatment of Stress Urinary Incontinence: A Cost-Effectiveness Analysis

Mobile App for Treatment of Stress Urinary Incontinence: A Cost-Effectiveness Analysis

24/7 usage of continence pads and quality of life impairment in women with urinary incontinence

Cost Effectiveness analysis of Surgical Treatment of Stress Urinary Incontinence Using Single-Incision Mini-Slings vs. Tension-Free Vaginal Obturator in Spain

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