Freemantle, N;
Khalaf, K;
Loveman, C;
Stanisic, S;
Gultyaev, D;
Lister, J;
Drake, M;
(2016)
OnabotulinumtoxinA in the treatment of overactive bladder: a cost-effectiveness analysis versus best supportive care in England and Wales.
European Journal of Health Economics
, 17
(7)
pp. 911-921.
10.1007/s10198-015-0737-2.
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Abstract
The cost-effectiveness of onabotulinumtoxinA (BOTOX®) 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.
| Type: | Article |
|---|---|
| Title: | OnabotulinumtoxinA in the treatment of overactive bladder: a cost-effectiveness analysis versus best supportive care in England and Wales |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s10198-015-0737-2 |
| Publisher version: | http://dx.doi.org/10.1007/s10198-015-0737-2 |
| Language: | English |
| Additional information: | Copyright © The Author(s) 2015. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
| Keywords: | Social Sciences, Science & Technology, Life Sciences & Biomedicine, Economics, Health Policy & Services, Business & Economics, Health Care Sciences & Services, Overactive bladder, OnabotulinumtoxinA, Incontinence, Cost-effectiveness, quality-of-life, sacral nerve-stimulation, placebo-controlled trial, urinary-incontinence, botulinum toxin, psychometric performance, discontinuation rates, detrusor overactivity, urge incontinence, extended-release |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > Comprehensive CTU at UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1519785 |
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