PD25-10 COST-UTILITY ANALYSIS IN UROLOGY

Abstract

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes Measures II (PD25)1 Sep 2021PD25-10 COST-UTILITY ANALYSIS IN UROLOGY Katherine Fero, Vidit Sharma, Patrick Lec, Christopher Saigal, and Karim Chamie Katherine FeroKatherine Fero More articles by this author , Vidit SharmaVidit Sharma More articles by this author , Patrick LecPatrick Lec More articles by this author , Christopher SaigalChristopher Saigal More articles by this author , and Karim ChamieKarim Chamie More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002018.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Cost-effectiveness analysis (CEA) defines value in healthcare by quantifying the benefit of an intervention for a given dollar expense. Cost-utility analysis (CUA) is a type of CEA that quantifies an intervention’s health benefits in terms of quality-adjusted life years (QALY’s). Understanding the CUA supporting an intervention is valuable in defining its best use. Here we characterize the state of cost-utility research in urology by evaluating the quality of published studies and reporting adherence to methodological guidelines. METHODS: We performed an analysis of all CUAs in the Cost-Effectiveness Analysis Registry (CEAR) published between 1976 and 2019. Studies on topics related to urology were screened by diagnosis code and then by title review. Studies were assigned to a urologic subspecialty by abstract review. Intervention studied, perspective, and quality score (1-7) are reported per CEAR abstraction processes. Associations between study characteristics and quality scores were evaluated using the Pearson product moment correlation coefficient. Mean quality scores between subspecialties were compared with ANOVA. RESULTS: 9080 articles were screened; 254 (2.8%) were pertinent to urology and were included in this analysis. There was an increase in studies published over the study period with a peak in 2013 (Figure 1a). Figure 1b shows the distribution of studies published by subspecialty. There were more CUA of pharmaceuticals than surgeries (38% vs 26%). Few modeled a reference case from the societal perspective (15%), most were from a payer perspective (62.6%). There was no change in proportion of studies reporting reference case from a societal perspective after the publication of guidelines recommending its use (p=0.38). A more recent publication year was associated with a higher study quality score (correlation co-efficient 0.18; p=0.004). No differences in quality were found by subspecialty (p=0.2), or between urology and non-urology CUA (mean score 4.7 vs 4.7). CONCLUSIONS: CUAs in urology make up a small fraction of published CEA research. More numerous and higher quality analyses have been published in recent years. Surgical interventions are understudied in urology and should be an area of focus for future analysis. Attention should be paid to methodological rigor, including use of recommended reference case perspective, when CEAs are considered for publication. Source of Funding: KEF Supported by H&H Lee Surgical Scholars (UCLA) © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e435-e436 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Katherine Fero More articles by this author Vidit Sharma More articles by this author Patrick Lec More articles by this author Christopher Saigal More articles by this author Karim Chamie More articles by this author Expand All Advertisement Loading ...