Millions of people experience bladder control problems or urinary incontinence, which can cause great a burden. In Spain, up to 19.9% of adults experience this condition and related costs incurred by the Spanish Health Service exceed 700m euros annually. First-line treatment is drugs. Nevertheless, while many patients remain on drugs despite unpleasant side effects and little improvement, others seek alternative treatments. Sacral nerve stimulation (SNS) through minor surgery is intended when drugs have failed and it is recommended in clinical guidelines before considering invasive surgery. Another treatment option is repetitive botulinum toxin A (BTA) injections to the bladder wall but this treatment is awaiting Health Authority approval for treating incontinence.
A cost-effectiveness assessment was conducted to consider the value of SNS to the Spanish Health Service compared with repetitive BTA injections or continued drug use in patients with unmanageable bladder control problems. Study results show that the higher initial costs of SNS are balanced with reduced incontinence episodes and improved quality of life. Furthermore, in a period of ten years, SNS results in lower costs.
The authors, a group of Spanish urologists and economists, mention that there is a need to assess the long-term value of incontinence treatments options and determine the best option for each patient.
This will be discussed in Value in Health, the official journal of the International Society for Pharmacoeconomics and outcomes Research.
Source:
ISPOR