OBJECTIVE-To estimate costs for incontinence management, health-related quality of life, and willingness to pay for incontinence improvement in women electing surgery for stress urinary incontinence.
METHODS-A total of 655 incontinent women enrolled in the Stress Incontinence SurgicalTreatment Efficacy Trial, a randomized surgical trial. Baseline out-of-pocket costs for incontinence management were calculated by multiplying self-report of resources used (supplies, laundry, dry cleaning) by national resource costs ($2006). Health-related quality of life was estimated with the Health Utilities Index Mark 3. Participants estimated willingness to pay for 100% improvement in incontinence. Potential predictors of these outcomes were examined by using multivariable linear regression.RESULTS-Mean age was 52±10 years, and mean number of weekly incontinence episodes was 22±21. Mean and median (25%, 75% interquartile range) estimated personal costs for incontinence management among all women were $14±$24 and $8 (interquartile range $3, $18) per week, and (Raritan, NJ). He also received grants and contracts from Allergan and GlaxoSmithKline (Philadelphia, PA). Dr. Goode has received honoraria from Otho McNeil (Titusville, NJ). Dr. Lukacz has served as a consultant to and speaker for Pfizer Pharmaceuticals, Inc., and served as a speaker for Novartis Pharmaceuticals, Inc. (Basel, Switzerland). The other authors have no potential conflicts to disclose. CONCLUSION-Urinary incontinence is associated with substantial costs. Women spent nearly $750 per year out of pocket for incontinence management, had a significant decrement in quality of life, and were willing to pay nearly $1,400 per year for cure.
NIH Public AccessUrinary incontinence is common among middle aged and older women and is associated with substantial "costs." In addition to high economic costs, urinary incontinence (UI) results in medical and psychological morbidity and diminished quality of life. 1,2 The economic costs of UI are substantial, accounting for over $20 billion per year in the United States, 3 with a majority (50-75%) attributed to resources used for incontinence management or "routine care" such as absorbent pads, protection, and laundry. Cost estimates vary widely between studies ($50 to $1000 per person per year) and by method of cost determination. 3-9 Studies suggest that costs increase with severity of UI, with expenses for women with daily UI estimated as fourfold higher than for women with weekly UI. 6,7 However, there are no primary data quantifying costs for UI management or the predictors of incontinence-related spending among women seeking surgical treatment for UI.Incontinence is also associated with a profound adverse effect on quality of life. 1,2,10-12 Although many studies have quantified the impact of incontinence on general and incontinence-specific quality of life using instruments like the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Incontinence Impact Questionnaire, there is less known about t...