Cost Effectiveness of Sacral Neuromodulation and OnabotulinumtoxinA in Managing Refractory Idiopathic Overactive Bladder

Tay, Li June; Harry, Deepak; Malde, Sachin; Sahai, Amit

doi:10.1016/j.urology.2020.11.018

Cited by 4 publications

(4 citation statements)

References 27 publications

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“…However, it was concluded that after 5 years SNM becomes a more cost-effective option, and prior to that BTX is more cost-effective, which is consistent with the findings of our study. 9 There were limitations in this analysis. Several assumptions had to be made, including the time of effectiveness of each treatment type as well as the frequency of treatments pursued by patients when analyzing long-term costs.…”

Section: Discussionmentioning

confidence: 96%

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Long-Term Cost Analysis of Third-Line Treatment Options for Overactive Bladder

Pelling,

Hammett,

Patil

2024

Urology Practice

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Introduction: We aimed to analyze the long-term cost of overactive bladder third-line treatments.Methods: This insurance claims review analyzed the 2015 to 2020 MarketScan (MKS) claims data set subjects age ! 18, diagnosis of overactive bladder (OAB) using ICD-9/ICD-10 codes and receipt of treatment for percutaneous tibial nerve stimulation, sacral neuromodulation (SNM), or botulinum A. Age, gender, treatment types, and cost were extracted. Treatment costs were aggregated at the level of patient and treatment type for total payment and patient contribution by combining copay, coinsurance, and deductible. We used the Wilcoxon rank-sum test for continuous and chi-square test for categorical variables. SAS v9.4 was used for analyses. Significance was set at P < .05. Results:We identified 17,755 patients from the commercial claims MKS and 10,912 patients from the Medicare supplemental (MDC) database with mean age 50.7AE11.1 and 75.5AE7.6 years, respectively, who underwent ! 1 third-line OAB treatment. Patients receiving third-line treatment were predominantly female (84.9%, MKS, 74.8%, MDC). Long-term costs over a 15-year period were estimated. Percutaneous tibial nerve stimulation is the most expensive in terms of total net payment

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Section: Discussionmentioning

confidence: 96%

“…However, it was concluded that after 5 years SNM becomes a more cost-effective option, and prior to that BTX is more cost-effective, which is consistent with the findings of our study. 9…”

Section: Discussionmentioning

confidence: 99%

Long-Term Cost Analysis of Third-Line Treatment Options for Overactive Bladder

Pelling,

Hammett,

Patil

2024

Urology Practice

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“…The procedure can be performed under different types of anesthesia [ 29 , 30 ]. To be cost-effective compared to sacral neuromodulation, local anesthesia should be the preferred technique [ 31 ]. In our survey, we found that in German-speaking countries general anesthesia is the most frequently used type of anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Techniques for the Use of Botulinum Toxin in Overactive Bladder: Results of a Multinational Online Survey of Urogynecologists in Germany, Austria, and Switzerland

Lange

Koch

Lange

et al. 2023

JCM

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Introduction and Hypothesis: Botulinum toxin (BoNT) is a widely used treatment for overactive bladder (OAB). Despite its common use, no standardized treatment regimen exists so far. The aim of this survey was to evaluate the variation in perioperative treatment strategies among members of the German-speaking urogynecologic societies. Materials and Methods: A clinical practice online survey was carried out between May 2021 and May 2022, and all members of the German, Swiss, and Austrian urogynecologic societies were invited to participate. Participants were grouped in two ways. First, they were grouped into (1) urogynecologists with board certification and (2) non-board-certified general obstetricians and gynecologists (OBGYNs). Second, we set a cut-off at 20 transurethral BoNT procedures per year to differentiate between (1) high- and (2) low-volume surgeons. Results: One hundred and six completed questionnaires were received. Our results demonstrated that BoNT is mostly used as a third-line treatment (93%, n = 98/106), while high-volume surgeons used it significantly more often as a first/second-line treatment (21% vs. 6%, p = 0.029). Large variations existed in the use of perioperative antibiotics, preferred sites of injection, the number of injections, and the timing of the measurement of the postvoid residual volume (PVRV). Forty percent of participants did not offer outpatient treatment to patients. Local anesthesia (LA) was mostly used by board-certified urogynecologists (49% vs. 10%, p < 0.001) and high-volume surgeons (58% vs. 27%, p = 0.002). Injections into the trigone were also more often performed by board-certified urogynecologists and high-volume surgeons (22% vs. 3% (p = 0.023) and 35% vs. 6% (p < 0.001), respectively). PVRV was controlled between weeks 1 and 4 by only 54% of participants (n = 57/106). Clean intermittent self-catheterization (CISC) was infrequently taught (26%). Conclusions: Our survey confirmed that BoNT is widely used by urogynecologists in the three German-speaking countries, but practice patterns vary widely, and no standardized method could be detected, despite interviewing urogynecologic experts. These results clearly demonstrate that there is a need for studies to define standardized treatment strategies for the best perioperative and surgical approach regarding the use of BoNT in patients with OAB.

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“…AAM tedavisinde BoNTA ve SNM uygulamasının güvenlik ve maliyet karşılaştırılmasının yapıldığı bir çalışmada SNM uygulamasının çok daha maliyetli ancak yan etki görülme sıklığının daha az olduğu saptanmıştır (12). Dirençli AAM tedavisinde BonT-A ve SNM tedavilerinin maliyetetkinlik kıyaslamasının değerlendirildiği başka bir derlemede; SNM' nin daha uzun vadede, BonT-A'nın ise 5 yıldan kısa vadede daha maliyet-etkin olduğu belirtilmektedir, ancak çalışmalar arasındaki heterojenite nedeniyle genel bir yorum yapmak için uzun dönem takipli klinik çalışmalara ihtiyaç olduğu vurgulanmaktadır (13). Dirençli AAM tedavisinde BonT-A ve SNM uygulaması etkinlik mekanizmalarını ve tercih önceliğini değerlendiren bir derlemede ise; SNM'nin uzun vadede BoNT-A'dan daha iyi bir seçim olabileceği;…”

Section: şEkil-1 Sakral Sinir Stimülatörü S3 Transforaminal Uygulama ...unclassified

Aşırı Aktif Mesane Yönetiminde Sakral Nöromodülasyon Uygulamaları

GÜNER,

EYİGÖR

2024

Ege Tıp Dergisi

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Sakral nöromodülasyon uygulamaları; aşırı aktif mesane, kronik üriner retansiyon, interstisyel sistit, fekal inkontinans ve kronik kabızlık gibi pek çok konservatif tedaviye dirençli kronik pelvik ağrı tedavisinde kullanılabilen etkin tedavi seçenekleridir. Kronik ağrıda nörostimülasyon uygulamaları giderek popüler hale gelmiştir. Aşırı aktif mesane tedavisinde sakral nöromodülasyon uygulamaları % 61 ile 90 arasında değişen oranda fayda göstermektedir. Sakral nöromodülasyon uygulaması iki aşamadan oluşur; ilk aşama deneme (trial) periyodu, ikinci aşama ise kalıcı pil yerleştirilmesidir. Gelişen teknoloji ile birlikte daha küçük boyutlu, manyetik rezonans görüntüleme uyumlu ve sarj edilebilir stimülatör seçenekleri ortaya çıkmıştır. Bu hastalar multidisipliner yaklaşımla ele alınmalı ve tedavi buna göre planlanmalıdır. Bu derlemede aşırı aktif mesane tedavi yönetiminde sakral nöromodülasyon uygulamaları literatür rehberliğinde anlatılmaktadır.

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Cost Effectiveness of Sacral Neuromodulation and OnabotulinumtoxinA in Managing Refractory Idiopathic Overactive Bladder

Cited by 4 publications

References 27 publications

Long-Term Cost Analysis of Third-Line Treatment Options for Overactive Bladder

Long-Term Cost Analysis of Third-Line Treatment Options for Overactive Bladder

Perioperative Techniques for the Use of Botulinum Toxin in Overactive Bladder: Results of a Multinational Online Survey of Urogynecologists in Germany, Austria, and Switzerland

Aşırı Aktif Mesane Yönetiminde Sakral Nöromodülasyon Uygulamaları

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