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dc.contributor.authorVon Bargen, Emily
dc.contributor.authorPatterson, Danielle
dc.date2022-08-11T08:10:06.000
dc.date.accessioned2022-08-23T16:55:48Z
dc.date.available2022-08-23T16:55:48Z
dc.date.issued2015-05-01
dc.date.submitted2017-08-11
dc.identifier.citationFemale Pelvic Med Reconstr Surg. 2015 May-Jun;21(3):150-3. doi: 10.1097/SPV.0000000000000159. <a href="https://doi.org/10.1097/SPV.0000000000000159">Link to article on publisher's site</a>
dc.identifier.issn2151-8378 (Linking)
dc.identifier.doi10.1097/SPV.0000000000000159
dc.identifier.pmid25679355
dc.identifier.urihttp://hdl.handle.net/20.500.14038/42790
dc.description.abstractOBJECTIVE: We sought to investigate the cost utility of nonsurgical versus surgical treatments for stress urinary incontinence (SUI). METHODS: A decision analysis model was created to compare nonsurgical and surgical treatment options for women with SUI. Decision paths included conservative management, pelvic floor physical therapy (pelvic floor muscle training [PFMT]), PFMT with electrical stimulation, incontinence pessary, and surgical treatment. A Markov model cohort analysis was performed with a cycle length of 1 year starting at age 45 years with a lifetime horizon. Probabilities, success rates, and utilities were obtained from the literature when available or by expert opinion. Cost-utility analysis was performed using US recommendations from a societal perspective. Cost data were obtained from Medicare reimbursement in 2012 US dollars. RESULTS: Incontinence pessary was the most cost-effective treatment option with a cost of $11,411 for 18.9 quality-adjusted life years. At a willingness to pay (WTP) threshold of $50,000, incontinence pessary remained the most cost-effective treatment option. At a WTP threshold of $60,000, surgery became the most cost-effective treatment option. The PFMT and PFMT with electrical stimulation were dominated at any WTP threshold. CONCLUSIONS: Surgical correction is likely the most cost-effective treatment option for young healthy women with SUI. Results are driven by the high success rate of minimally invasive slings. More studies are needed to define utility values for heath states experienced by women with SUI. This will enhance our ability to develop more accurate cost-utility models and offer the best treatment for women affected by incontinence.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=25679355&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttps://doi.org/10.1097/SPV.0000000000000159
dc.subjectFemale Urogenital Diseases and Pregnancy Complications
dc.subjectMaternal and Child Health
dc.subjectObstetrics and Gynecology
dc.subjectWomen's Health
dc.titleCost utility of the treatment of stress urinary incontinence
dc.typeJournal Article
dc.source.journaltitleFemale pelvic medicine and reconstructive surgery
dc.source.volume21
dc.source.issue3
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/obgyn_pp/145
dc.identifier.contextkey10586770
html.description.abstract<p>OBJECTIVE: We sought to investigate the cost utility of nonsurgical versus surgical treatments for stress urinary incontinence (SUI).</p> <p>METHODS: A decision analysis model was created to compare nonsurgical and surgical treatment options for women with SUI. Decision paths included conservative management, pelvic floor physical therapy (pelvic floor muscle training [PFMT]), PFMT with electrical stimulation, incontinence pessary, and surgical treatment. A Markov model cohort analysis was performed with a cycle length of 1 year starting at age 45 years with a lifetime horizon. Probabilities, success rates, and utilities were obtained from the literature when available or by expert opinion. Cost-utility analysis was performed using US recommendations from a societal perspective. Cost data were obtained from Medicare reimbursement in 2012 US dollars.</p> <p>RESULTS: Incontinence pessary was the most cost-effective treatment option with a cost of $11,411 for 18.9 quality-adjusted life years. At a willingness to pay (WTP) threshold of $50,000, incontinence pessary remained the most cost-effective treatment option. At a WTP threshold of $60,000, surgery became the most cost-effective treatment option. The PFMT and PFMT with electrical stimulation were dominated at any WTP threshold.</p> <p>CONCLUSIONS: Surgical correction is likely the most cost-effective treatment option for young healthy women with SUI. Results are driven by the high success rate of minimally invasive slings. More studies are needed to define utility values for heath states experienced by women with SUI. This will enhance our ability to develop more accurate cost-utility models and offer the best treatment for women affected by incontinence.</p>
dc.identifier.submissionpathobgyn_pp/145
dc.contributor.departmentDepartment of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery
dc.source.pages150-3


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