Long-term cost-effectiveness analysis of sacral neuromodulation in the treatment of severe faecal incontinence
Aim: The aim of this study was to evaluate the long-term cost-effectiveness of sacralneuromodulation in the treatment of severe faecal incontinence as compared with symp-tomatic management.Methods: In the public health field, a micro-costing evaluation method was conductedfrom the perspectives of th...
| Autores: | , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión aceptada para publicación |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | Universidad Pública de Navarra |
| Repositorio: | Academica-e. Repositorio Institucional de la Universidad Pública de Navarra |
| OAI Identifier: | oai:academica-e.unavarra.es:2454/56105 |
| Acceso en línea: | https://hdl.handle.net/2454/56105 |
| Access Level: | acceso abierto |
| Palabra clave: | Cost-effectiveness Faecal incontinence Long-term Sacral neuromodulation |
| Sumario: | Aim: The aim of this study was to evaluate the long-term cost-effectiveness of sacralneuromodulation in the treatment of severe faecal incontinence as compared with symp-tomatic management.Methods: In the public health field, a micro-costing evaluation method was conductedfrom the perspectives of the health system and the society. The incremental cost-effectiveness ratio was used as a decision index, and we considered various scenariosto evaluate the impact of the cost of symptomatic management and percutaneous nerveevaluation success rate in its calculation. Clinical data were retrieved from a consecutivecohort of 93 patients with severe faecal incontinence undergoing sacral neuromodula-tion after a failure of conservative (pharmacological and biofeedback) and/or surgical(sphincteroplasty) first-line treatments were considered.Results: The long-term incremental cost-effectiveness ratio comparing sacral neuromod-ulation versus symptomatic management was 14347€/QALY and 28523€/QALY from thesocietal and health service provider's perspectives, respectively. If the definitive pulsegenerator implant success rate was 100%, incremental cost-effectiveness would corre-spond to 6831€/QALY and 16761€/QALY, respectively.Conclusions: Sacral neuromodulation may be considered a cost-effective technique inthe long-term treatment of severe faecal incontinence from the societal and health caresector perspectives. Improving patient selection and determining the predictive outcomefactors for successful sacral neuromodulation in the treatment of faecal incontinencewould improve cost-effectiveness. |
|---|