HOW CAN A LOW COST ECONOMIC PERSPECTIVE BE INCLUDED TO A SYSTEMATIC REVIEW- A CASE STUDY OF SYSTEMATIC REVIEW OF SURGICAL TREATMENTS FOR WOMEN WITH STRESS URINARY INCONTINENCE

Author(s)

Aluko PO1, Vale L1, Craig D1, Shemilt I2, On behalf of the Campbell and Cochrane Economic methods Group .1
1Newcastle University, Newcastle upon Tyne, UK, 2University College London, London, UK

OBJECTIVES:  Extending the scope of Cochrane Intervention Reviews (CIRs) to incorporate economic evidence, alongside evidence for health effects, can increase their usefulness for decision-making. However, the primary methodology for incorporating economic evidence into a CIR – an integrated full systematic review of economic evidence – is time consuming and requires specialist input from a health economist. The Brief Economic Commentary (BEC) methodology is especially designed to support inclusion of economic evidence in CIRs, without placing large additional workload on review teams or requiring specialist input. We demonstrated this framework by applying it in Cochrane reviews investigating the effectiveness and cost-effectiveness of surgical treatments for women with stress urinary incontinence. METHODS:  NHS Economic Evaluation Database and MEDLINE were searched to identify eligible cost-of-illness and economic evaluation studies conducted between 1994 and 2016. A short description of the economic burden of the health condition was developed based on the findings of selected cost-of-illness studies and integrated into the background section of the CIR. Basic details of the characteristics and principal findings of included economic evaluations were extracted and summarised in the discussion section. RESULTS: Eligible economic evaluations studies included a systematic review covering various countries and three primary studies from the UK, Finland and Spain. Of the surgeries considered, all of these studies found Tension-free Vaginal Tape (TVT) to be more cost-effective compared with Laparoscopic mesh colposuspension and open colposuspension. However, two studies reported Mid-Urethral Sling procedure (MUS), a much recent surgery, to be less costly and as effective as TVT. CONCLUSIONS: This work confirmed that BECs can summarise relevant economic information for decision-makers without large additional workload. Development of BECs represents a low cost method for inclusion of economic evidence in systematic reviews when a full integrated systematic review of economic evidence, or modelling economic evidence is beyond scope.

Conference/Value in Health Info

2017-05, ISPOR 2017, Boston, MA, USA

Value in Health, Vol. 20, No. 5 (May 2017)

Code

PUK25

Topic

Health Policy & Regulatory, Health Technology Assessment

Topic Subcategory

Decision & Deliberative Processes, Pricing Policy & Schemes

Disease

Reproductive and Sexual Health, Urinary/Kidney Disorders

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