COST-EFFECTIVENESS ANALYSIS OF SURGICAL MANAGEMENT OF STRESS URINARY INCONTINENCE WITH SINGLE-INCISION MINI-SLING VERSUS TENSION-FREE VAGINAL OBTURATOR IN SPAIN
Author(s)
Castañeda E1, Sanz-Granda Á2, Hidalgo A2, Meza DF1, Marqueta JM1, Carreras M1
1Hospital de Palamós, Palamós, Girona, Spain, 2Weber, Economía y Salud, Majadahonda, Madrid, Spain
OBJECTIVES: To analyze the cost effectiveness of surgical management of stress urinary incontinence (SUI) in women with single-incision mini-sling (SIMS) compared with tension-free vaginal obturator (TVT-O) METHODS : A cost-effectiveness analysis based on the results of interventions performed with TVT-O (2005-2008) and SIMS (2008-2011) in women with a diagnosis of SUI was performed. The clinical effectiveness was defined as an objective cure at 12 months (pad-test <1 g/h). A perspective of the hospital payer was adopted; therefore, only direct healthcare costs (diagnostic and surgical procedures, medical devices, medications, hospital stay times and staff) were included. CI95% of total cost was estimated by bootstrapping; later, different sensitivity analyses were conducted RESULTS :Procedures were carried out in 81 women (44 in the SIMS group and 37 in the TVT-O) was lower (2,059€; CI95%: 1,914-2,285) than with TVT-O (2,821€; CI95%: 2,661-2,997), showing a statistically significant cost saving of 762€ (CI95%: 516-987). In the base case, the probability of SIMS is less costly than TVT-O was 100%. The sensitivity analysis showed that the cost determinant was the length of the hospital stay, observing that an equivalent cost was only achieved if there was no cause for any hospital stay with TVT-O CONCLUSIONS : The use of single-incision mini-sling is associated with an comparable clinical effectiveness but with a 762€ per patient reduction of the average annual cost, compared to tension-free vaginal obturator. Therefore, the results suggest that, over a post-operative period of twelve months, tension-free tape single-incision mini-sling is a dominant alternative to tension-free vaginal obturator because of a lower cost and a comparable effectiveness
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PIH26
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Reproductive and Sexual Health, Urinary/Kidney Disorders