Estimating the Burden of Illness and Healthcare Costs Among Incident Catheter Users: A Comparison of Intermittent and Indwelling Catheter Cohorts Across Spinal Cord Injury, Multiple Sclerosis, Spina Bifida, and Benign Prostatic Hyperplasia in the US

Author(s)

George Skountrianos, BS, MS, Stacy Haddad, MS;
Hollister Incorporated, Global Market Access, Libertyville, IL, USA

Presentation Documents

OBJECTIVES: This study evaluated healthcare resource utilization (HCRU) and costs among incident intermittent catheter (IC) and indwelling catheter (IDC) users in the United States, focusing on all-cause, sepsis-related, urinary tract infection (UTI)-related, and urinary retention (UR)-related events across four bladder dysfunction (BD) conditions: spinal cord injury (SCI), multiple sclerosis (MS), spina bifida (SB), and benign prostatic hyperplasia (BPH).
METHODS: Retrospective analysis conducted using Optum's de-identified Clinformatics® Data Mart Database (2016-2023). Eligible patients were incident IC or IDC users identified through HCPCS codes (A4351, A4352, A4353, or IDC-related codes) with continuous commercial or Medicare Advantage health plan enrollment during a 1-year baseline and at least 2-month post-index period. Propensity score-based overlap weighting was applied to adjust for baseline differences in age, sex, region, health plan type, BD-related conditions, and urinary tract conditions. HCRU endpoints included hospitalizations and emergency room (ER) visits, stratified by all-cause, sepsis-related, UTI-related, and UR-related events. Costs were calculated annually and HCRU rates evaluated using multivariable Cox proportional hazards models.
RESULTS: Among ~3,000 total incident catheter users, IC users had significantly lower rates of hospitalizations and ER visits compared to IDC users during the 12-month follow-up. IC use was associated with a decreased risk of hospitalizations across the SCI, MS, SB, and BPH cohorts, ranging from 10-72% reduction. Similarly, IC users incurred lower average annualized healthcare costs compared to IDC users across all conditions. For instance, SCI patients incurred $106,317 (IC) vs. $175,293 (IDC) in all-cause costs, $18,533 (IC) vs $45,214 (IDC) in sepsis-related costs, $22,281 (IC) vs. $51,709 (IDC) in UTI-related costs, and $12,551 (IC) vs $27,450 (IDC) in UR-related costs.
CONCLUSIONS: IC use is associated with significantly lower HCRU and costs compared to IDC use across diverse BD conditions. These findings suggest IC may be a more cost-effective catheterization approach, particularly for high-risk patient groups.

Conference/Value in Health Info

2025-05, ISPOR 2025, Montréal, Quebec, CA

Value in Health, Volume 28, Issue S1

Code

EE246

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies

Disease

SDC: Neurological Disorders, SDC: Urinary/Kidney Disorders

Your browser is out-of-date

ISPOR recommends that you update your browser for more security, speed and the best experience on ispor.org. Update my browser now

×