Cost-Effectiveness Analysis of Anticholinergics Versus Botox for Urgency Urinary Incontinence: Results From the Anticholinergic Versus Botox Comparison Randomized Trial
Year: 2016
Type: article
Abstract: OBJECTIVES: This study aimed to compare the cost-effectiveness of Botox and anticholinergic (AC) medications for the management of urgency urinary incontinence (UUI). METHODS: Cost and effectiveness data were analyzed from participants in the Anticholinergic versus Botox Comparison randomized trial of daily AC medication versus 100 U of intradetrusor Botox injection. Societal costs included the following: treatment costs, patient costs, and medical and nonmedical utilization during the 6-month trial. Quality-adjusted life-years (QALYs) were calculated based on questionnaire-derived utility measures and annualized based on data collected at baseline through 6 months. We also estimated the average direct costs for each treatment through 9 months - the duration of time when approximately half the Botox participants maintained adequate symptom control. RESULTS: Data were analyzed on the 231 women who completed a 6-month follow-up in the Anticholinergic versus Botox Comparison trial (119 AC and 112 Botox). The mean reduction in UUI episodes per day was not significantly different per group. The cumulative mean direct costs through the first 6 months also were similar: $1339 for the AC group and $1266 for the Botox group with AC costs exceeding Botox costs after 5 months. Both groups had considerable QALY gains. Annualizing the 6-month trial results to a 12-month measure, the AC and Botox groups averaged 0.702 and 0.707 QALYs, respectively. Estimates through 9 months favored Botox, showing that AC participants incurred a higher cost per month of adequate symptoms control ($305) compared with Botox participants ($207). CONCLUSIONS: Botox and AC medications have similar costs and effectiveness in the first 6 months of UUI treatment. If costs and outcomes are considered through 9 months, Botox may have significantly lower costs but similar UUI symptom control as AC.
Source: Urogynecology
Institutions: Cleveland Clinic, University of Pittsburgh, Loyola University Chicago, University of Utah, University of Michigan, University of Alabama at Birmingham, University of California San Diego, Duke Medical Center, The University of Texas Southwestern Medical Center, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, RTI International, UC San Diego Health System
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Cleveland Clinic, University of Texas Southwestern Medical Center, National Institutes of Health, University of California, San Diego, National Institute of Child Health and Human Development, Office of Research on Women's Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1222322107, G1967102714, G2516686185, G2540549055, G2602659566, Pelvic Floor Disorders Network Clinical Sites, G390348850, G4157666827, G4354517318, G4547005390, G5058561277, Cleveland Clinic Clinical Site, G5418896253, G5709676798, G5827047038, G6069452013, G6732265442, G6821603532, Pelvic Floor Disorders Network - Duke University Clinical Site, G8563561067, Clinical and Translational Resaerch in the Pelvic Floor Disorders Network, G866024349, Pelvic Floor Disorders Network
OpenAlex ID: W2512398012