INTRODUCTION: To evaluate the cost-utility of incontinence treatments, particularly anticholinergic therapy, by examining costs and quality-adjusted life years. MATERIALS AND METHODS: A prospective cohort study of women who were consecutively referred by general practitioners (GPs) to the Urology Department because of urinary incontinence. The primary outcome was evaluation of the cost-utility of incontinence treatments (surgery, medical therapy and physiotherapy) for stress and/or urgency incontinence by examining costs and quality-adjusted life years. RESULTS: 137 consecutive female patients (mean age 60.6 ± 11.6; range 36-81) were enrolled and stratified according to pathologies: SUI and UUI. Group A: SUI grade II-III: 43 patients who underwent mid-urethral sling (MUS); Group B: SUI grade I-II 57 patients who underwent pelvic floor muscle exercise and Group C: UUI: 37 patients who underwent antimuscarinic treatment with 5 mg solifenacin daily. The cost utility ratio (CUR) was estimated as saving more than €1200 per QALY for surgery and physiotherapy and as costing under € 100 per QALY for drug therapy. CONCLUSIONS: This study shows that appropriate diagnosis and treatment of a patient with incontinence lowers National Health Service costs and improves the benefits of treatment and quality of life.
INTRODUCTION: To evaluate the cost-utility of incontinence treatments, particularly anticholinergic therapy, by examining costs and quality-adjusted life years. MATERIALS AND METHODS: A prospective cohort study of women who were consecutively referred by general practitioners (GPs) to the Urology Department because of urinary incontinence. The primary outcome was evaluation of the cost-utility of incontinence treatments (surgery, medical therapy and physiotherapy) for stress and/or urgency incontinence by examining costs and quality-adjusted life years. RESULTS: 137 consecutive female patients (mean age 60.6 ± 11.6; range 36-81) were enrolled and stratified according to pathologies: SUI and UUI. Group A: SUI grade II-III: 43 patients who underwent mid-urethral sling (MUS); Group B: SUI grade I-II 57 patients who underwent pelvic floor muscle exercise and Group C: UUI: 37 patients who underwent antimuscarinic treatment with 5 mg solifenacin daily. The cost utility ratio (CUR) was estimated as saving more than €1200 per QALY for surgery and physiotherapy and as costing under € 100 per QALY for drug therapy. CONCLUSIONS: This study shows that appropriate diagnosis and treatment of a patient with incontinence lowers National Health Service costs and improves the benefits of treatment and quality of life.
Authors: Mehdi Javanbakht; Eoin Moloney; Miriam Brazzelli; Sheila Wallace; Muhammad Imran Omar; Ash Monga; Lucky Saraswat; Phil Mackie; Mari Imamura; Jemma Hudson; Michal Shimonovich; Graeme MacLennan; Luke Vale; Dawn Craig Journal: Syst Rev Date: 2020-04-20
Authors: Mehdi Javanbakht; Eoin Moloney; Miriam Brazzelli; Sheila Wallace; Laura Ternent; Muhammad Imran Omar; Ash Monga; Lucky Saraswat; Phil Mackie; Frauke Becker; Mari Imamura; Jemma Hudson; Michal Shimonovich; Graeme MacLennan; Luke Vale; Dawn Craig Journal: BMJ Open Date: 2020-06-11 Impact factor: 2.692