A cost-effectiveness analysis of bladder management strategies in neurogenic lower urinary tract dysfunction after spinal cord injury: A publicly funded health care perspective.
Journal
Spinal cord
ISSN: 1476-5624
Titre abrégé: Spinal Cord
Pays: England
ID NLM: 9609749
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
received:
05
01
2022
accepted:
23
02
2023
revised:
22
01
2023
medline:
5
4
2023
pubmed:
10
3
2023
entrez:
9
3
2023
Statut:
ppublish
Résumé
Economic evaluation study. To investigate the long-term cost-effectiveness of clean intermittent catheterization (CIC) compared with suprapubic catheters (SPC) and indwelling urethral catheters (UC) among individuals with neurogenic lower urinary tract dysfunction (NLUTD) related to spinal cord injury (SCI) from a public healthcare perspective. University affiliated hospital in Montreal, Canada. A Markov model with Monte Carlo simulation was developed with a cycle length of 1 year and lifetime horizon to estimate the incremental cost per quality-adjusted life years (QALYs). Participants were assigned to treatment with either CIC or SPC or UC. Transition probabilities, efficacy data, and utility values were derived from literature and expert opinion. Costs were obtained from provincial health system and hospital data in Canadian Dollars. The primary outcome was cost per QALY. Probabilistic and one-way deterministic sensitivity analyses were performed. CIC had a lifetime mean total cost of $ 29,161 for 20.91 QALYs. The model predicted that a 40-year-old person with SCI would gain an additional 1.77 QALYs and 1.72 discounted life-years gained if CIC were utilized instead of SPC at an incremental cost savings of $330. CIC confer 1.96 QALYs and 3 discounted life-years gained compared to UC with an incremental cost savings of $2496. A limitation of our analysis is the lack of direct long-term comparisons between different catheter modalities. CIC appears to be a dominant and more economically attractive bladder management strategy for NLUTD compared with SPC and/or UC from the public payer perspective over a lifetime horizon.
Identifiants
pubmed: 36894764
doi: 10.1038/s41393-023-00883-5
pii: 10.1038/s41393-023-00883-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
269-275Informations de copyright
© 2023. The Author(s), under exclusive licence to International Spinal Cord Society.
Références
Ku JH. The management of neurogenic bladder and quality of life in spinal cord injury. BJU Int. 2006;98:739–45.
doi: 10.1111/j.1464-410X.2006.06395.x
pubmed: 16978269
Krueger H, Noonan V, Trenaman L, Joshi P, Rivers C. The economic burden of traumatic spinal cord injury in Canada. Chronic Dis injuries Can. 2013;33:113–22.
doi: 10.24095/hpcdp.33.3.01
Feifer A, Corcos J. Contemporary role of suprapubic cystostomy in treatment of neuropathic bladder dysfunction in spinal cord injured patients. Neurourol Urodyn. 2008;27:475–9.
doi: 10.1002/nau.20569
pubmed: 18551568
Kavanagh A, Baverstock R, Campeau L, Carlson K, Cox A, Hickling D, et al. Canadian urological association guideline: diagnosis, management, and surveillance of neurogenic lower urinary tract dysfunction–full text. Can Urol Assoc J. 2019;13:E157.
pubmed: 30763235
pmcid: 6570608
White BAB, Dea N, Street JT, Cheng CL, Rivers CS, Attabib N, et al. The Economic burden of urinary tract infection and pressure ulceration in acute traumatic spinal cord injury admissions: evidence for comparative economics and decision analytics from a matched case-control study. J Neurotrauma. 2017;34:2892–900.
doi: 10.1089/neu.2016.4934
pubmed: 28791891
Krebs J, Wöllner J, Pannek J. Risk factors for symptomatic urinary tract infections in individuals with chronic neurogenic lower urinary tract dysfunction. Spinal Cord. 2016;54:682–6.
doi: 10.1038/sc.2015.214
pubmed: 26620878
Katsumi H, Kalisvaart J, Ronningen L, Hovey R. Urethral versus suprapubic catheter: choosing the best bladder management for male spinal cord injury patients with indwelling catheters. Spinal cord. 2010;48:325.
doi: 10.1038/sc.2009.134
pubmed: 19823191
Krebs J, Wöllner J, Pannek J. Urethral strictures in men with neurogenic lower urinary tract dysfunction using intermittent catheterization for bladder evacuation. Spinal cord. 2015;53:310.
doi: 10.1038/sc.2015.15
pubmed: 25644391
Vekeman F, Yameogo N-D, Lefebvre P, Bailey RA, McKenzie RS, Piech CT. Healthcare costs associated with nephrology care in pre-dialysis chronic kidney disease patients. J Med Econ. 2010;13:673–80.
doi: 10.3111/13696998.2010.529032
pubmed: 21050062
Ku JH, Choi WJ, Lee KY, Jung TY, Lee JK, Park WH, et al. Complications of the upper urinary tract in patients with spinal cord injury: a long-term follow-up study. Urol Res. 2005;33:435–9.
doi: 10.1007/s00240-005-0504-4
pubmed: 16317536
Center NSCIS. National Spinal Cord Injury Statistical Center Annual Statistical Report. Birmingham, AL, University of Alabama at Birmingham. 2019.
Groen J, Pannek J, Diaz DC, Del Popolo G, Gross T, Hamid R, et al. Summary of European Association of Urology (EAU) guidelines on neuro-urology. Eur Urol. 2016;69:324–33.
doi: 10.1016/j.eururo.2015.07.071
pubmed: 26304502
Bermingham SL, Hodgkinson S, Wright S, Hayter E, Spinks J, Pellowe C. Intermittent self catheterisation with hydrophilic, gel reservoir, and non-coated catheters: a systematic review and cost effectiveness analysis. BMJ. 2013;346:e8639.
doi: 10.1136/bmj.e8639
pubmed: 23303886
pmcid: 3541473
Ontario HQ. Intermittent Catheters for chronic urinary retention: A health technology assessment. Ont Health Technol Assess Ser. 2019;19:1.
Clark JF, Mealing SJ, Scott DA, Vogel LC, Krassioukov A, Spinelli M, et al. A cost-effectiveness analysis of long-term intermittent catheterisation with hydrophilic and uncoated catheters. Spinal Cord. 2015. https://doi.org/10.1038/sc.2015.117 .
Régie de l’assurance maladie du Québec: Manuel des médecins spécialistes. http://www.ramq.gouv.qc.ca/fr/professionnels/medecinsspecialistes/manuels/Pages/remuneration-acte.aspx (2019). Accessed June 2019.
Gouvernement du Québec: Ministère de la Santé et des Services sociaux. www.informa.msss.gouv.qc.ca (2015). Accessed June 2019.
SCI supply inc.: https://www.scisupply.ca/intermittent-catheters (2019). Accessed May 2019.
CathetersPLUS™: https://www.cathetersplus.com/ (2019). Accessed May 2019.
Laupacis A, Feeny D, Detsky AS, Tugwell PX. How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations. CMAJ: Can Med Assoc J. 1992;146:473.
Griffiths E, Vadlamudi NK. Cadth’s $50,000 cost-effectiveness threshold: Fact or fiction? Value Health. 2016;19:A488–A9.
doi: 10.1016/j.jval.2016.09.821
Weld KJ, DMOCHOWSKI RR. Effect of bladder management on urological complications in spinal cord injured patients. J Urol. 2000;163:768–72.
doi: 10.1016/S0022-5347(05)67800-7
pubmed: 10687973
Bennett CJ, Young MN, Adkins RH, Diaz F. Comparison of bladder management complication outcomes in female spinal cord injury patients. J Urol. 1995;153:1458–60.
doi: 10.1016/S0022-5347(01)67432-9
pubmed: 7714965
Wyndaele J-J, Maes D. Clean intermittent self-catheterization: A 12-year followup. J Urol. 1990;143:906–8.
doi: 10.1016/S0022-5347(17)40132-7
pubmed: 2329604
Gao Y, Danforth T, Ginsberg DA. Urologic management and complications in spinal cord injury patients: A 40-to 50-year follow-up study. Urology 2017;104:52–8.
doi: 10.1016/j.urology.2017.03.006
pubmed: 28322903
Chai T, Chung A, Belville W, Faerber G. Compliance and complications of clean intermittent catheterization in the spinal cord injured patient. Spinal Cord. 1995;33:161–3.
doi: 10.1038/sc.1995.35
Afsar S, Yemisci O, Cosar S, Cetin N. Compliance with clean intermittent catheterization in spinal cord injury patients: a long-term follow-up study. Spinal Cord. 2013;51:645.
doi: 10.1038/sc.2013.46
pubmed: 23752262
Cameron AP, Wallner LP, Tate DG, Sarma AV, Rodriguez GM, Clemens JQ. Bladder management after spinal cord injury in the United States 1972 to 2005. J Urol. 2010;184:213–7.
doi: 10.1016/j.juro.2010.03.008
pubmed: 20478597
Krebs J, Wöllner J, Pannek J. Bladder management in individuals with chronic neurogenic lower urinary tract dysfunction. Spinal Cord. 2016;54:609–13.
doi: 10.1038/sc.2015.196
pubmed: 26554274
Welk B, Isaranuwatchai W, Krassioukov A, Husted Torp L, Elterman D. Cost-effectiveness of hydrophilic-coated intermittent catheters compared with uncoated catheters in Canada: a public payer perspective. J Med Econ. 2018;21:639–48.
doi: 10.1080/13696998.2018.1443112
pubmed: 29458282