Clinical and Economic Burden Among Patients Requiring Long-Term Intermittent Catheter Use in England: A Real-World Retrospective Observational Cohort Study
Author(s)
Jalesh Panicker, MD1, Gareth Jones, ACC2, Fiona Mthombeni, MSc3, Angela Crossland, BA3, Cameron Costello, MPH4, Zarena Jafry, MPH5, Tatjana Marks, MSc4, Jennifer Page, BSc6, Anna Willis, MPH4, Audrey Artignan, MPhil7, Amy Buchanan-Hughes, MSci5.
1National Hospital for Neurology and Neurosurgery, London, United Kingdom, 2Manchester University NHS Trust, Manchester, United Kingdom, 3Coloplast, Peterborough, United Kingdom, 4Costello Medical, London, United Kingdom, 5Costello Medical, Boston, MA, USA, 6Costello Medical, Manchester, United Kingdom, 7Costello Medical, Cambridge, United Kingdom.
1National Hospital for Neurology and Neurosurgery, London, United Kingdom, 2Manchester University NHS Trust, Manchester, United Kingdom, 3Coloplast, Peterborough, United Kingdom, 4Costello Medical, London, United Kingdom, 5Costello Medical, Boston, MA, USA, 6Costello Medical, Manchester, United Kingdom, 7Costello Medical, Cambridge, United Kingdom.
OBJECTIVES: To characterise the burden among patients requiring long-term intermittent catheter (IC) use to manage chronic urinary retention in England.
METHODS: This was a retrospective cohort study using the Clinical Practice Research Datalink-Hospital Episode Statistics linked databases (January 1, 2011 - December 31, 2020). Eligible patients were ≥18 years old with long-term IC use (≥3 IC prescriptions in primary care within consecutive intervals of ≤4 months; ≥6 months total duration), propensity-score matched 1:5 by age, sex and calendar year with non-catheterising individuals from the general population. Patient characteristics, occurrence of urinary tract infections (UTIs), health care resource use (HCRU) and costs were analysed up to 1 year from index (the first eligible IC prescription or matching general practitioner [GP] visit).
RESULTS: In total, 3,520 IC users and 15,643 matched uncatheterised individuals from the general population were included, with mean ages of 61 years each; 61% and 57% were men, 94% and 71% were white, respectively. Among IC users, “UTI, site not specified” was the most common reason for GP visits; chronic kidney disease was the most common reason for hospitalisation. Mean all-cause healthcare costs (GP visits, hospitalisations, outpatient and emergency department visits) were £4,710 for IC users and £1,498 for uncatheterised individuals (P<0.001). Most IC users (70%) had UTI-related antibiotic prescriptions (mean, 4.24), though only 30% had recorded UTI diagnoses, compared with 21% of uncatheterised individuals with UTI-related antibiotic prescriptions (mean, 0.40) and 4% with UTI diagnoses (all P<0.001). Prevalence of UTI-related healthcare visits was approximately 10 times greater among IC users than uncatheterised individuals (GP visits, 26% vs 3%; hospitalisations, 5% vs 0.4%; 30-day readmissions, 0.5% vs <0.1%). Mean costs for UTI-related visits were £76.31 vs £7.61, respectively (P<0.001).
CONCLUSIONS: Long-term IC users incur high HCRU and related costs, driven by hospitalisations and antibiotic prescriptions, particularly for UTI-related care.
METHODS: This was a retrospective cohort study using the Clinical Practice Research Datalink-Hospital Episode Statistics linked databases (January 1, 2011 - December 31, 2020). Eligible patients were ≥18 years old with long-term IC use (≥3 IC prescriptions in primary care within consecutive intervals of ≤4 months; ≥6 months total duration), propensity-score matched 1:5 by age, sex and calendar year with non-catheterising individuals from the general population. Patient characteristics, occurrence of urinary tract infections (UTIs), health care resource use (HCRU) and costs were analysed up to 1 year from index (the first eligible IC prescription or matching general practitioner [GP] visit).
RESULTS: In total, 3,520 IC users and 15,643 matched uncatheterised individuals from the general population were included, with mean ages of 61 years each; 61% and 57% were men, 94% and 71% were white, respectively. Among IC users, “UTI, site not specified” was the most common reason for GP visits; chronic kidney disease was the most common reason for hospitalisation. Mean all-cause healthcare costs (GP visits, hospitalisations, outpatient and emergency department visits) were £4,710 for IC users and £1,498 for uncatheterised individuals (P<0.001). Most IC users (70%) had UTI-related antibiotic prescriptions (mean, 4.24), though only 30% had recorded UTI diagnoses, compared with 21% of uncatheterised individuals with UTI-related antibiotic prescriptions (mean, 0.40) and 4% with UTI diagnoses (all P<0.001). Prevalence of UTI-related healthcare visits was approximately 10 times greater among IC users than uncatheterised individuals (GP visits, 26% vs 3%; hospitalisations, 5% vs 0.4%; 30-day readmissions, 0.5% vs <0.1%). Mean costs for UTI-related visits were £76.31 vs £7.61, respectively (P<0.001).
CONCLUSIONS: Long-term IC users incur high HCRU and related costs, driven by hospitalisations and antibiotic prescriptions, particularly for UTI-related care.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE128
Topic
Economic Evaluation, Medical Technologies, Real World Data & Information Systems
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Neurological Disorders, Urinary/Kidney Disorders