Cost-Effectiveness of a Sublingual Bacterial Vaccine for the Prophylaxis of Recurrent Urinary Tract Infections

Abstract

<b><i>Introduction:</i></b> Recurrent urinary tract infections (rUTIs) affect 5–10% of women, resulting in an enormous healthcare and society burden. Uromune® is a polybacterial sublingual vaccine with an excellent clinical benefit in rUTI prophylaxis. This study assesses the impact of sublingual vaccination on healthcare resource use and expenditures associated with this pathology. <b><i>Methods:</i></b> A quasi-experimental, pretest-posttest, single center study including women with rUTI and vaccinated with Uromune® in real-life clinical practice was performed. Variables were the need of healthcare resources, collected prospectively during two follow-up years, and the rUTI-associated expenditure, calculated using the micro-costing methodology; these were compared before and after vaccination. <b><i>Results:</i></b> A total of 166 women {mean (standard deviation [SD]) urinary tract infection episodes/year 6.19 (2.15)} were included. After vaccination, annual consultations with a primary care physician (PCP) (43.9%), emergency room visits (71.8%), urinary analysis (90.0%), and ultrasound exams (35.6%) decreased compared to pre-vaccination (all <i>p</i> < 0.001). Per patient consumption in antibiotics, PCP consultations, emergency room visits, and complementary exams significantly decreased (all <i>p</i> < 0.02), resulting in a reduction in healthcare expenditure per patient/year from mean (SD) 1,001.1 (655.0) to 497.1 (444.4) EUR. <b><i>Conclusion:</i></b> Sublingual bacterial vaccination with Uromune® decreased healthcare resource use and associated expenditure in women with rUTI, representing an optimal strategy to reduce rUTI-associated healthcare and economic burden.

Immunoactive Prophylaxis Protocol of Uncomplicated Recurrent Urinary Tract Infections in a Cohort of 1104 Women Treated with Uromune® Vaccine

“…The reason for this was also the difference in sample size: 166 compared to 1104. In any case, the objective of our study was not to reach 0-1 UTIs after vaccination, but to consider that the treatment was effective when it presented 0-2 UTIs [2].…”

“…Escherichia coli is the most common pathogen for 80% of all UTIs [1]. In the USA, more than 11 million women suffer more than one UTI per year, with a direct cost of USD 659 million [2].…”

An Effective Sublingual Vaccine, MV140, Safely Reduces Risk of Recurrent Urinary Tract Infection in Women

“…It is logical that a reduction in UTI risk would translate into decreased healthcare utilization (fewer trips to seek medical attention, fewer urine cultures, etc.,) and antibiotic cost. A recent quasi-experimental, pretest–post-test, single-center study [ 47 ] including 166 women with rUTI, vaccinated with MV140 in real-life clinical practice, prospectively assessed healthcare utilization and associated costs. Primary care physician and emergency room visits, urine cultures, ultrasound exams (and other ancillary testing), and antibiotic costs significantly decreased compared to prevaccination (all p < 0.001).…”

Autovaccine-Based Immunotherapy: A Promising Approach for Male Recurrent Urinary Tract Infections

“…Immunoprophylaxis in the form of autovaccines has been used as a strategy to prevent recurrent urinary tract infections (UTIs) in some patients and currently has the highest recommendation grade while being cost efficient [2,9,10]. Nevertheless, the recommendations are the same for both genders, even if most of the evidence was obtained in women.…”

“…In addition to reducing the number of UTIs, vaccines have the potential to also reduce the costs associated with repeat infections. In a study that compared the use of vaccines with the use of prophylactic antibiotics, it was demonstrated that per patient consumption of antibiotics, consultations, emergency room visits, and complementary exams significantly decreased, resulting in a reduction in healthcare expenditure per patient/year from mean (SD) 1001.1 (655.0) to 497.1 (444.4) EUR [10].…”