Cost-Effectiveness of the Application of Botulinum Toxin Versus Biofeedback as Treatment in Patients With Anismus

Abstract

INTRODUCTION Anismus is a pathology that is responsible for up to 50% of constipation cases, there are mainly 2 treatments: biofeedback and the use of botulinum toxin, with similar results. Does the application of botulinum toxin have a better cost-effectiveness index compared to biofeedback as a treatment in patients with anismus? The objective is to establish whether the application of botulinum toxin as a treatment in patients with anismus represents a better cost-effectiveness index compared to biofeedback. MATERIAL AND METHODS A randomized prospective cost-effectiveness trial was conducted evaluating the effectiveness of biofeedback treatment compared to the application of botulinum toxin in patients with anismus. Patients were followed up at month 1, 3, and 6 after management. RESULTS A total of 9 patients were included, 4 in the botulinum toxin group and 5 in the biofeedback group. The efficacy of botulinum toxin was 75% at month 1 and 3 and 50% at month 6. The efficacy of biofeedback remained at 80% at 6 months. The expense for biofeedback treatment was $ 17,458.32 MXN compared to $ 7,846.08 MXN for botulinum toxin. CONCLUSION A decrease in the average cost of $ 9,612.24 MXN was obtained in favor of the use of botulinum toxin for the treatment of anismus.