Long-term results of a multicenter study on sacral nerve stimulation for treatment of urinary urge incontinence, urgency-frequency, and retention

Siegel, Steven; Catanzaro, F.; Dijkema, H.E.; Elhilali, Mostafa; Fowler, Clare J.; Gajewski, Jerzy; Hassouna, Magdy; Janknegt, R. A.; Jonas, Udo; Kerrebroeck, Philip E. V. A. Van; Nijeholt, A.A.B. Lycklama à; Oleson, Kimberly A.; Schmidt, Richard A.

doi:10.1016/s0090-4295(00)00597-5

Cited by 372 publications

(240 citation statements)

References 10 publications

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“…Temporary PNE electrodes were removed in all patients who did not respond in the testing phase (based on NICE Guidelines) [5,20]. It was assumed that 7 % of patients who did not respond to SNS would have the device explanted [21][22][23][24][25][26], and that among those who did respond, 23 % would undergo surgical revision [21,[23][24][25][26][27]. It was assumed that individuals would have three physician visits for SNS device programming per year [28].…”

Section: Resource Use and Costmentioning

confidence: 99%

OnabotulinumtoxinA in the treatment of overactive bladder: a cost-effectiveness analysis versus best supportive care in England and Wales

Freemantle¹,

Khalaf

Loveman

et al. 2015

Eur J Health Econ

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The cost-effectiveness of onabotulinumtoxinA (BOTOX Ò ) 100 U ? best supportive care (BSC) was compared with BSC alone in the management of idiopathic overactive bladder in adult patients who are not adequately managed with anticholinergics. BSC included incontinence pads and, for a proportion of patients, anticholinergics and/or occasional clean intermittent catheterisation. A five-state Markov model was used to estimate total costs and outcomes over a 10-year period. The cohort was based on data from two placebo-controlled trials and a long-term extension study of onabotulinumtoxinA. After discontinuation of initial treatment, a proportion of patients progressed to downstream sacral nerve stimulation (SNS). Cost and resource use was estimated from a National Health Service perspective in England and Wales using relevant reference sources for 2012 or 2013. Results showed that onabotulinumtoxinA was associated with lower costs and greater health benefits than BSC in the base case, with probabilistic sensitivity analysis indicating an 89 % probability that the incremental cost-effectiveness ratio would fall below £20,000. OnabotulinumtoxinA remained dominant over BSC in all but two scenarios tested; it was also economically dominant when compared directly with SNS therapy. In conclusion, onabotulinumtoxinA appears to be a cost-effective treatment for overactive bladder compared with BSC alone.

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Section: Resource Use and Costmentioning

confidence: 99%

OnabotulinumtoxinA in the treatment of overactive bladder: a cost-effectiveness analysis versus best supportive care in England and Wales

Freemantle¹,

Khalaf

Loveman

et al. 2015

Eur J Health Econ

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“…3 About 12% to 18% of Canadians live with some form of OAB, with prevalence figures of about 3.1% in men and 14.7% in women; however, these figures fail to account for the underdiagnosed problem of incontinence. [4][5][6] The pathology of the disorder suggests a disruption of the spinal reflex mechanism that carries sensory signals from autonomic and somatic pathways from the bladder outlet and tonic inhibitory system in the brain. 7 This disruption creates inhibits the control function of the parasympathetic excitatory outflow of the urinary bladder.…”

Section: Introductionmentioning

confidence: 99%

“…9,11 The estimated annual cost of OAB per patient to the Canadian health system is about $11 329 per annum. 4,9 Different treatment options are available for OAB, including lifestyle or behavioural changes, such as pelvic floor strengthening, bladder retraining, and management of daily Economic evaluation of SNM in OAB fluid intake. 4,12 Optimal medical therapy (OMT) typically aims to restore normal function of the bladder storage phase by relaxing the bladder musculature to render it compliant to urine filling.…”

Section: Introductionmentioning

confidence: 99%

“…4,9 Different treatment options are available for OAB, including lifestyle or behavioural changes, such as pelvic floor strengthening, bladder retraining, and management of daily Economic evaluation of SNM in OAB fluid intake. 4,12 Optimal medical therapy (OMT) typically aims to restore normal function of the bladder storage phase by relaxing the bladder musculature to render it compliant to urine filling. 4 Several approved medications are used in management of OAB in Canada including: oxybutynin chloride, tolterodine tartrate, trospium chloride, solifenacin succinate, darifenacin hydrobromide, and fesoterodine fumarate.…”

Section: Introductionmentioning

confidence: 99%

“…4,12 Optimal medical therapy (OMT) typically aims to restore normal function of the bladder storage phase by relaxing the bladder musculature to render it compliant to urine filling. 4 Several approved medications are used in management of OAB in Canada including: oxybutynin chloride, tolterodine tartrate, trospium chloride, solifenacin succinate, darifenacin hydrobromide, and fesoterodine fumarate. 10 These anticholinergic drugs are intended to block the acetylcholine transmitter in the bladder through the muscarinic receptor subtypes in the detrusor muscle.…”

Section: Introductionmentioning

confidence: 99%

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Economic evaluation of sacral neuromodulation in overactive bladder: A Canadian perspective

Hassouna

Sadri

2015

CUAJ

Self Cite

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Introduction: Refractory overactive bladder (OAB) with urge incontinence is an underdiagnosed condition with substantial burden on the healthcare system and diminished patient's quality-of-life. Many patients will fail conservative treatment with optimized medical-therapy (OMT) and may benefit from minimally invasive procedures, including sacral-neuromodulation (SNM) or botulinum-toxin (BonT-A). The goal of this study was to estimate the costefectiveness of SNM vs. OMT and BonT-A as important parameters from coverage and access to a therapy. Methods: A Markov model with Monte-Carlo simulation was used to assess the incremental cost effectiveness ratio (ICER) of SNM vs. BonT-A and OMT both in deterministic and probabilistic analysis from a provincial payer perspective over a 10-year time horizon with 9-month Markov-cycles. Clinical data, healthcare resource utilization, and utility scores were acquired from recent publications and an expert panel of 7 surgeons. Cost data (2014-Dollars) were derived from provincial health insurance policy, drug benefit formulary, and hospital data. All cost and outcomes were discounted at a 3% rate. Results: The annual (year 1-10) incremental quality-adjusted life years for SNM vs. BonT-A was 0.05 to 0.51 and SNM vs. OMT was 0.19 to 1.76. The annual incremental cost of SNM vs. BonT-A was $7237 in year 1 and -$9402 in year 10 and was between $8878 and -$11 447 vs. OMT. In the base-case deterministic analysis, the ICER for SNM vs. BonT-A and OMT were within the acceptable range ($44 837 and $15 130, respectively) at the second year of therapy, and SNM was dominant in consequent years. In the basecase analysis the probability of ICER being below the acceptability curve (willingness-to-pay $50 000) was >99% for SNM vs. BonT-A at year 3 and >95% for OMT at year 2. Conclusion: SNM is a cost-effective treatment option to manage patients with refractory OAB when compared to either BonT-A or OMT. From a Canadian payers' perspective, SNM may be considered a first-line treatment option in management of patients with OAB with superior long-term outcomes. Similar to all economic analysis, this study has limitations which are based on the assumptions of the used model.

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Quality of Life and Morbidity After Permanent Sacral Nerve Stimulation for Fecal Incontinence

Hetzer

Hahnloser²,

Clavien³

et al. 2007

Arch Surg

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Long-term results of a multicenter study on sacral nerve stimulation for treatment of urinary urge incontinence, urgency-frequency, and retention

Cited by 372 publications

References 10 publications

OnabotulinumtoxinA in the treatment of overactive bladder: a cost-effectiveness analysis versus best supportive care in England and Wales

OnabotulinumtoxinA in the treatment of overactive bladder: a cost-effectiveness analysis versus best supportive care in England and Wales

Economic evaluation of sacral neuromodulation in overactive bladder: A Canadian perspective

Quality of Life and Morbidity After Permanent Sacral Nerve Stimulation for Fecal Incontinence

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