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Cost‐effectiveness of an Internet‐based treatment program for stress urinary incontinence
Author(s) -
Sjöström Malin,
Umefjord Göran,
Lindholm Lars,
Samuelsson Eva
Publication year - 2015
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22540
Subject(s) - medicine , urinary incontinence , urology , the internet , gynecology , world wide web , computer science
Aims To perform a deterministic cost‐utility analysis, from a 1‐year societal perspective, of two treatment programs for stress urinary incontinence (SUI) without face‐to‐face contact: one Internet‐based and one sent by post. The treatments were compared with each other and with no treatment. Methods We performed this economic evaluation alongside a randomized controlled trial. The study included 250 women aged 18–70, with SUI ≥ 1 time/week, who were randomized to 3 months of pelvic floor muscle training via either an Internet‐based program including e‐mail support from an urotherapist (n = 124) or a program sent by post (n = 126). Recruitment was web‐based, and participants were self‐assessed with validated questionnaires and 2‐day bladder diaries, supplemented by a telephone interview with a urotherapist. Treatment costs were continuously registered. Data on participants' time for training, incontinence aids, and laundry were collected at baseline, 4 months, and 1 year. We also measured quality of life with the condition‐specific questionnaire ICIQ‐LUTSqol, and calculated the quality‐adjusted life‐years (QALYs) gained. Baseline data remained unchanged for the no treatment option. Sensitivity analysis was performed. Results Compared to the postal program, the extra cost per QALY for the Internet‐based program ranged from 200€ to 7,253€, indicating greater QALY‐gains at similar or slightly higher costs. Compared to no treatment, the extra cost per QALY for the Internet‐based program ranged from 10,022€ to 38,921€, indicating greater QALY‐gains at higher, but probably acceptable costs. Conclusion An Internet‐based treatment for SUI is a new, cost‐effective treatment alternative. Neurourol. Urodynam. 34:244–250, 2015 . © 2013 The Authors. Neurourology and Urodynamics published by Wiley Periodicals, Inc.