OBJECTIVES:

The aim of the analysis was to estimate the threshold price of single-use Micro-hole Zone Technology (MZT) catheters compared to single-use hydrophilic-coated intermittent catheters (HCICs) for urinary catheterisation based on a willingness to pay (WTP) threshold of £20,000/QALY and to evaluate associated healthcare system costs.

METHODS:

The analysis was conducted using an existing health-economic Markov model to estimate the potential price of novel MZT catheters. It was based on health-related quality of life and cost impact of intermittent catheter (IC) associated urinary tract infection (UTI) at a WTP threshold of £20,000/QALY in accordance with NICE guidelines. The analysis focused on an intermittent self-catheterising spinal cord injury population in a UK National Health Service (NHS) perspective. Efficacy data were collected from published evidence, a time trade-off study and patient experience evaluation, and were supported by expert opinions. Treatment costs were derived from Drug Tariff and NHS pay scales. The model outputs included lifetime costs, QALYs and incremental cost-effectiveness ratio (ICER).

RESULTS:

The analysis showed that MZT catheters are cost-effective at the ICER threshold of £20,000/QALY and a price of up to £2.41 compared to an average cost of £1.88 per catheter for HCICs. The incremental life-time cost of MZT was estimated at £13,061 compared to use of HCICs per patient. Over a lifetime, the use of MZT increased QALYs by 0.65 and reduced 6 IC associated UTI events per patient, thereby reducing associated antibiotic use and hospitalisations. Key drivers of the model results were identified and subject to sensitivity analyses.

CONCLUSIONS:

MZT catheters were found to be a cost-effective treatment compared to HCICs with a price of up to £2.41 per catheter at a WTP threshold of £20,000/QALY. Their adoption across clinical practice could potentially avoid a substantial number of infections for intermittent urinary catheter users and thereby release resources in the NHS.