Cost effectiveness of radiofrequency microremodeling for stress urinary incontinence
| Autor: | Louise H. Anderson, Peter K. Sand, Melissa Martinson, Edward J. Black, Gary M. Owens |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Sling (implant) Cost effectiveness Urology Urinary Incontinence Stress Urinary incontinence Transurethral Adult women Sling Obstetrics and Gynaecology Medicine PROXIMAL URETHRA Humans Burch Work productivity Stress urinary incontinence business.industry Obstetrics and Gynecology Female bladder neck Radiofrequency Therapy Nonsurgical treatment Models Economic Radiofrequency Original Article Female medicine.symptom business |
| Zdroj: | International Urogynecology Journal |
| ISSN: | 1433-3023 0937-3462 |
| Popis: | Introduction and hypothesis Stress urinary incontinence (SUI) is a common and growing problem among adult women and affects individuals and society through decreased quality of life (QoL), decreased work productivity, and increased health care costs. A new, nonsurgical treatment option has become available for women who have failed conservative therapy, but its cost effectiveness has not been evaluated. This study examined the cost effectiveness of transurethral radiofrequency microremodeling of the female bladder neck and proximal urethra compared with synthetic transobturator tape (TOT), retropubic transvaginal tape (TVT) sling, and Burch colposuspension surgeries for treating SUI. Methods A Markov model was used to compare the cost effectiveness of five strategies for treating SUI for patients who had previously failed conservative therapy. The strategies were designed to compare the value of starting with a less invasive treatment. The cost-effectiveness analysis was conducted from the health care system perspective. Efficacy and adverse event rates were obtained from the literature; reimbursement costs were based on Medicare fee schedule. The model cycle was 3 months, with a 3-year time horizon. Single-variable sensitivity analyses were conducted to assess stability of base-case results. Results Two of the five strategies employed the use of transurethral radiofrequency microremodeling and achieved 17–30 % lower mean costs relative to their comparative sling or Burch strategies. Conclusions Superior safety and cost effectiveness are recognized when patients are offered a sequential approach to SUI management that employs transurethral radiofrequency microremodeling before invasive surgical procedures. This sequential approach is consistent with treatment strategies for other conditions and offers a solution for women with SUI who want to avoid the inherent risks and costs of invasive continence surgery. |
| Databáze: | OpenAIRE |
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