Cost-effectiveness of a pro-active approach of urinary incontinence in women

K. M. Vermeulen; E. Visser; E. J. Messelink; A. J. Schram; M. Y. Berger; G. H. de Bock; J. H. Dekker

doi:10.1111/1471-0528.13856

Cost-effectiveness of a pro-active approach of urinary incontinence in women

K. M. Vermeulen^*, E. Visser, E. J. Messelink, A. J. Schram, M. Y. Berger, G. H. de Bock, J. H. Dekker

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

7 Citations (Scopus)

Abstract

Objective To estimate the cost-effectiveness and cost-utility of actively encouraging older community-dwelling women with urinary incontinence to be diagnosed and treated.

Design The study was designed as cost-effectiveness and cost-utility analyses alongside a cluster randomised controlled trial. Analyses were performed from a societal perspective. Direct medical and nonmedical costs were taken into account and valued according to the standard Dutch guidelines for economic evaluations.

Setting Primary care.

Population Study participants were 350 community-dwelling women 55 years or older with urinary incontinence.

Methods Women in the intervention group were invited for diagnostic testing and treatment. The control group received usual care according to the Dutch guideline on urinary incontinence. Follow-up period was 12 months.

Main outcome measures Incontinence Impact Adjusted Life Years (IIALY), Quality Adjusted Life Years (QALY) and incremental costs calculated per IIALY and per QALY gained.

Results Costs per extra life year without impact on daily life from urinary incontinence amounted to (sic)5179 (95% CI -17 323 to 36 260). Costs per QALY amounted to (sic) 23 907 (95% CI -124 849 to 121 849). Assuming a ceiling ratio of (sic) 20 000, the probability that the intervention was cost-effective based on IIALYs was 91% and 46% based on QALYs.

Conclusions Improvements in severity of incontinence in older community-dwelling women can be achieved against reasonable costs, with an improvement of symptom-specific QALYs. Findings support an active role of primary care physicians towards women who hesitate to ask for help for urinary incontinence.

Original language	English
Pages (from-to)	1213-1220
Number of pages	8
Journal	BJOG : An International Journal of Obstetrics and Gynaecology
Volume	123
Issue number	7
DOIs	https://doi.org/10.1111/1471-0528.13856
Publication status	Published - Jun-2016

Keywords

Active approach
cost-effectiveness
costs
incontinence
primary care
QUALITY-OF-LIFE
UROGENITAL DISTRESS INVENTORY
IMPACT QUESTIONNAIRE
ECONOMIC BURDEN
PRIMARY-CARE
OLDER WOMEN
DYSFUNCTION
PREVALENCE
TRIAL

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Cost-effectiveness of a pro-active approach of urinary incontinence in women
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@article{07527a799e2146b4a02dfaf0e98668a9,

title = "Cost-effectiveness of a pro-active approach of urinary incontinence in women",

abstract = "Objective To estimate the cost-effectiveness and cost-utility of actively encouraging older community-dwelling women with urinary incontinence to be diagnosed and treated.Design The study was designed as cost-effectiveness and cost-utility analyses alongside a cluster randomised controlled trial. Analyses were performed from a societal perspective. Direct medical and nonmedical costs were taken into account and valued according to the standard Dutch guidelines for economic evaluations.Setting Primary care.Population Study participants were 350 community-dwelling women 55 years or older with urinary incontinence.Methods Women in the intervention group were invited for diagnostic testing and treatment. The control group received usual care according to the Dutch guideline on urinary incontinence. Follow-up period was 12 months.Main outcome measures Incontinence Impact Adjusted Life Years (IIALY), Quality Adjusted Life Years (QALY) and incremental costs calculated per IIALY and per QALY gained.Results Costs per extra life year without impact on daily life from urinary incontinence amounted to (sic)5179 (95% CI -17 323 to 36 260). Costs per QALY amounted to (sic) 23 907 (95% CI -124 849 to 121 849). Assuming a ceiling ratio of (sic) 20 000, the probability that the intervention was cost-effective based on IIALYs was 91% and 46% based on QALYs.Conclusions Improvements in severity of incontinence in older community-dwelling women can be achieved against reasonable costs, with an improvement of symptom-specific QALYs. Findings support an active role of primary care physicians towards women who hesitate to ask for help for urinary incontinence.",

keywords = "Active approach, cost-effectiveness, costs, incontinence, primary care, QUALITY-OF-LIFE, UROGENITAL DISTRESS INVENTORY, IMPACT QUESTIONNAIRE, ECONOMIC BURDEN, PRIMARY-CARE, OLDER WOMEN, DYSFUNCTION, PREVALENCE, TRIAL",

author = "Vermeulen, {K. M.} and E. Visser and Messelink, {E. J.} and Schram, {A. J.} and Berger, {M. Y.} and {de Bock}, {G. H.} and Dekker, {J. H.}",

year = "2016",

month = jun,

doi = "10.1111/1471-0528.13856",

language = "English",

volume = "123",

pages = "1213--1220",

journal = "BJOG : An International Journal of Obstetrics and Gynaecology",

issn = "1470-0328",

publisher = "Wiley",

number = "7",

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TY - JOUR

T1 - Cost-effectiveness of a pro-active approach of urinary incontinence in women

AU - Vermeulen, K. M.

AU - Visser, E.

AU - Messelink, E. J.

AU - Schram, A. J.

AU - Berger, M. Y.

AU - de Bock, G. H.

AU - Dekker, J. H.

PY - 2016/6

Y1 - 2016/6

N2 - Objective To estimate the cost-effectiveness and cost-utility of actively encouraging older community-dwelling women with urinary incontinence to be diagnosed and treated.Design The study was designed as cost-effectiveness and cost-utility analyses alongside a cluster randomised controlled trial. Analyses were performed from a societal perspective. Direct medical and nonmedical costs were taken into account and valued according to the standard Dutch guidelines for economic evaluations.Setting Primary care.Population Study participants were 350 community-dwelling women 55 years or older with urinary incontinence.Methods Women in the intervention group were invited for diagnostic testing and treatment. The control group received usual care according to the Dutch guideline on urinary incontinence. Follow-up period was 12 months.Main outcome measures Incontinence Impact Adjusted Life Years (IIALY), Quality Adjusted Life Years (QALY) and incremental costs calculated per IIALY and per QALY gained.Results Costs per extra life year without impact on daily life from urinary incontinence amounted to (sic)5179 (95% CI -17 323 to 36 260). Costs per QALY amounted to (sic) 23 907 (95% CI -124 849 to 121 849). Assuming a ceiling ratio of (sic) 20 000, the probability that the intervention was cost-effective based on IIALYs was 91% and 46% based on QALYs.Conclusions Improvements in severity of incontinence in older community-dwelling women can be achieved against reasonable costs, with an improvement of symptom-specific QALYs. Findings support an active role of primary care physicians towards women who hesitate to ask for help for urinary incontinence.

AB - Objective To estimate the cost-effectiveness and cost-utility of actively encouraging older community-dwelling women with urinary incontinence to be diagnosed and treated.Design The study was designed as cost-effectiveness and cost-utility analyses alongside a cluster randomised controlled trial. Analyses were performed from a societal perspective. Direct medical and nonmedical costs were taken into account and valued according to the standard Dutch guidelines for economic evaluations.Setting Primary care.Population Study participants were 350 community-dwelling women 55 years or older with urinary incontinence.Methods Women in the intervention group were invited for diagnostic testing and treatment. The control group received usual care according to the Dutch guideline on urinary incontinence. Follow-up period was 12 months.Main outcome measures Incontinence Impact Adjusted Life Years (IIALY), Quality Adjusted Life Years (QALY) and incremental costs calculated per IIALY and per QALY gained.Results Costs per extra life year without impact on daily life from urinary incontinence amounted to (sic)5179 (95% CI -17 323 to 36 260). Costs per QALY amounted to (sic) 23 907 (95% CI -124 849 to 121 849). Assuming a ceiling ratio of (sic) 20 000, the probability that the intervention was cost-effective based on IIALYs was 91% and 46% based on QALYs.Conclusions Improvements in severity of incontinence in older community-dwelling women can be achieved against reasonable costs, with an improvement of symptom-specific QALYs. Findings support an active role of primary care physicians towards women who hesitate to ask for help for urinary incontinence.

KW - Active approach

KW - cost-effectiveness

KW - costs

KW - incontinence

KW - primary care

KW - QUALITY-OF-LIFE

KW - UROGENITAL DISTRESS INVENTORY

KW - IMPACT QUESTIONNAIRE

KW - ECONOMIC BURDEN

KW - PRIMARY-CARE

KW - OLDER WOMEN

KW - DYSFUNCTION

KW - PREVALENCE

KW - TRIAL

U2 - 10.1111/1471-0528.13856

DO - 10.1111/1471-0528.13856

M3 - Article

SN - 1470-0328

VL - 123

SP - 1213

EP - 1220

JO - BJOG : An International Journal of Obstetrics and Gynaecology

JF - BJOG : An International Journal of Obstetrics and Gynaecology

IS - 7

ER -

Cost-effectiveness of a pro-active approach of urinary incontinence in women

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