Cost Utility Analysis of Sacral Neuro-Modulation vs Botox A in the Treatment of Overactive Bladder in Colombia

Abstract

1.1.Objectives: Cost Utility Analysis of Sacral Neuromodulation (SNM) vs. botulin toxin type A (BoNT-A) in Overactive Bladder (OAB) treatment in Colombia. 1.2.Methods: Through a HTA Consulting Discrete Event Simulation (DES) economic model adaptation, a cost-utility analysis of SNM vs. BoNT-A 100UI in the treatment of OAB in Colombia was done. The effectiveness data for SNM and BoNT-A, defined as more than 50% improvement in urinary parameters, was based on studies identified in systematic review Jaros 2013 conducted in Polish settings. Based in systematic search for quality of life (QoL) data, one health state for treatment success and one for treatment failure were defined. Costs data was obtained from Colombian Public Manual and urologist KOL which also adjusted the frequency of resources use. With 10 years horizon and a 3% discount rate deterministic and probabilistic sensitive analyses were done. 1.3.Results: SNM obtained 5.67 QALYs vs. 5.38 with BoNT-A with 0.28 incremental QALYs, with US$27,828 vs. US$28,906 total costs respectively. SNM was more effective and less costly, therefore been cost-saving. In the Probabilistic Sensitivity analysis 49.1% of the simulations fall in the NE quadrant, more effective and more costly, and 50.9% in the SE quadrant, more effective and less costly than BoNT-A, and 100% fall under the threshold of 3 Colombian GDP Per Capita. 1.4.Conclusion: SNM has higher effectiveness than BoNT-A in terms of QoL at a lower cost and compared to BoNT-A is cost-saving therapy for the treatment of OAB in Colombia. All the probabilistic results were cost-effective for Colombian Threshold.