PMD23 - Health Economic Evaluation of Hydrophilic Coated Versus Non-Coated Urinary Catheters for Intermittent Use in Japan

Abstract

Clinical evidence shows efficacy differences between catheters with hydrophilic surface and other non-coated catheters which require gel for lubrication, with reduced complication rates with hydrophilic catheters. Lower treatment costs for complications could compensate for a price difference between hydrophilic and non-coated catheters. The aim of this analysis was to investigate the possible price increase for hydrophilic catheters that would allow for a total cost-saving for the Japanese health care system. A Markov model simulating a population of 40 years old users of intermittent catheterization with costs from a Japanese setting was used for this analysis. During a time-horizon of 1 year, the simulated population was modelled to use either a hydrophilic catheter or a non-coated catheter. The monthly cost for non-coated catheters was 24,000 yen. Included catheter related complications and associated treatment costs per event were urinary tract infection (UTI; 80,719 yen), sepsis (2,643,084 yen), epididymitis (80,719 yen), stricture (238,972 yen) and bladder stones (257,435 yen). Absolute and relative risks for the complications were retrieved from the literature. During the year modelled, the efficacy difference gave fewer events of UTI (1.8 vs 2.2/patient), sepsis (0.07 vs 0.08/patient), epididymitis (0.002 vs 0.020/patient) and strictures (0.002 vs 0.020/patient) with hydrophilic catheters compared to non-coated catheters. The efficacy difference translated into reduced treatment costs for complications of 74,522 yen per patient. This allowed for a 25% increase in monthly catheter costs for hydrophilic catheters compared to non-coated catheters (30,000 yen vs 24,000 yen), without implying increased total health care costs. This analysis suggests that hydrophilic catheters can have a 25% higher price level than the non-coated catheters and still result in cost-savings for the Japanese health care system. At the same time, the patients would benefit from fewer complications.