PMD29 - Incontinence Control System (Interstim®) for the Fecal Incontinence Treatment at Healthcare Public Sector in Mexico

Abstract

The social impact of fecal incontinence (FI) could be devastating, that's the reason why FI could decrease QoL and trigger emotional issues. At the same time FI causes economic problems for the healthcare sector. Nowadays the Mexican clinical practice recommends graciloplasty for those patients who have failed to esfinteroplasty. In this sense, to demonstrate the suitability and the value for money of new alternatives, we designed and executed a full economic evaluation to assess the Incontinence Control System (Interstim®) for the treatment of fecal incontinence vs SoC available at healthcare public sector in Mexico. . A cost effectiveness analysis was designed through a deterministic approach (considering as a target population those patients who has failed to esfinteroplasty) in order to estimate those advantages (complete continence) derived from the Incontinence Control System vs surgical approach through 5-year horizon (additionally lifetime), 5% discount rate and challenging the results through sensitivity analysis After systematic literature review, meta-analysis and treatment comparison, we estimated an Odds Ratio of 3.98 (CI 95% 2.12 – 7.47), it means Interstim® better than surgical approach. The economic model demonstrates that Interstim® is a very cost-effectiveness strategy (< 1 GDP per capita, considering only costs discounting under 5-year time horizon) at healthcare public sector in Mexico (the percentage of patients who achieved complete continence was 20.41% as an incremental of effectiveness [31% vs 11%, Interstim® vs graciloplasty] and a 18% relative difference as an incremental on cost for Interstim® over surgical approach). Interstim® could be considered as a better alternative for those patients with FI who previously failed to first lines of treatment over surgical approaches in Mexico, in the light of the clinical and economic facts derived from treatment comparison and the suitability of the health economic model results.