Cost‐effectiveness analysis of tension‐free vaginal tape vs burch colposuspension for female stress urinary incontinence in the USA. (14th June 2013)

• Record Type: Journal Article
• Authors: Laudano, Melissa A.; Seklehner, Stephan; Chughtai, Bilal; Lee, Una; Tyagi, Renuka; Kavaler, Elizabeth; Te, Alexis E.; Kaplan, Steven A.; Lee, Richard K.
• Is Part Of: BJU international. Volume 112:Number 2(2013:Jul.)
• Page Start: E151
• Page End: E158
• Publication Date: 2013-06-14
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.12180
• Languages: English
• ISSNs: 1464-4096

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bju12180-sec-0001" sec-type="section"> <title>Objective</title> <p> <list id="bju12180-list-0001" list-type="bullet"> <list-item> <p>To compare the cost‐effectiveness (CE) of tension‐free vaginal tape (TVT) with that of burch colposuspension (BC) for the treatment of female stress urinary incontinence (SUI).</p> </list-item> </list> </p> </sec> <sec id="bju12180-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p> <list id="bju12180-list-0002" list-type="bullet"> <list-item> <p>A Markov‐chain decision model was created to simulate treatment of SUI with TVT or BC using Treeage Pro 2011 software (Treeage Software Inc., Williamstown, MA, USA).</p> </list-item> <list-item> <p>Costing data were obtained from the Medicare Resource‐Based Relative Value Scale.</p> </list-item> <list-item> <p>Data regarding the success of TVT vs BC were obtained from the peer‐reviewed literature, as were corresponding utilities for different continence states.</p> </list-item> <list-item> <p>The CE of each procedure was calculated and compared, and sensitivity analyses were performed.</p> </list-item> </list> </p> </sec> <sec id="bju12180-sec-0003" sec-type="section"> <title>Results</title> <p> <list id="bju12180-list-0003" list-type="bullet"> <list-item> <p>At 10‐year follow‐up, TVT was more cost‐effective (CE = $1495/quality‐adjusted life year [QALY]) than BC (CE = $1824/QALY).</p> </list-item> <list-item> <p>Sensitivity analysis showed that TVT was more cost‐effective than BC if the cost of the TVT device was <$3220.</p> </list-item> <list-item> <p>If the probability of success after TVT was <42%, then BC became the more cost‐effective strategy (CE = $1827/QALY).</p> </list-item> </list> </p> </sec> <sec id="bju12180-sec-0004" sec-type="section"> <title>Conclusion</title> <p> <list id="bju12180-list-0004" list-type="bullet"> <list-item> <p>Our study showed that TVT was more cost‐effective than BC as a treatment for female SUI.</p> </list-item> <list-item> <p>Both cost of TVT device and efficacy of the procedure affect the CE analysis.</p> </list-item> </list> </p> </sec> </abstract>