You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy I1 Apr 2016PD36-04 PERCUTANEOUS NERVE STIMULATION FOR OVERACTIVE BLADDER: COST-EFFECTIVENESS COMPARED TO MONO AND DUAL PHARMACOTHERAPY Julie Jenks, Eskinder Solomon, Mahreen Pakzad, Rizwan Hamid, Tamsin Greenwell, and Jeremy Ockrim Julie JenksJulie Jenks More articles by this author , Eskinder SolomonEskinder Solomon More articles by this author , Mahreen PakzadMahreen Pakzad More articles by this author , Rizwan HamidRizwan Hamid More articles by this author , Tamsin GreenwellTamsin Greenwell More articles by this author , and Jeremy OckrimJeremy Ockrim More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1109AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pharmacological treatments of overactive bladder (OAB) with anticholinergics and/or beta-3-adrenergic receptor agonists are standard treatment, but persistence with medical therapy is poor. Posterior tibial nerve stimulation (PTNS) is a minimally invasive alternative with few reported side effects but its cost effectiveness is unknown. We compared the cost effectiveness of PTNS with mono (anticholinergic) pharmacotherapy, dual (anticholinergics and beta-3-adrenergic) therapy within an NHS setting. METHODS Pharmacotherapy consisted of monotherapy with the anticholinergic Solifennacin 10mgs OD, and dual therapy with the beta-3-adrenergic receptor agonist Mirabegron 50mgs OD. PTNS was based on twelve weekly sessions, then top ups monthly. Treatment success was defined as >50% improvement in OAB symptoms. A Spanish Markov model was adapted to UK practice based on published efficacy data and expert opinion. Persistence for treatment was taken to be 24% for both mono and dual pharmacotherapy (published data) and 60% for PTNS (hospital data). Health resource use included pre-/peri-/and post-procedure assessments; adverse events and procedure (PTNS) costs. Incremental-cost-effectiveness-ratios (ICER; costs per quality-adjusted-life-year) were calculated for PTNS monotherapy versus monotherapy and PTNS versus dual therapy at 5yrs; with univariate sensitivity analyses. RESULTS At 5 years, the cumulative costs of monotherapy, dual therapy and PTNS therapy were £3,451, £5,222 and £8,011 respectively. The QALYs for monotherapy, dual therapy and PTNS therapy were 2.92, 3.11, and 3.45. ICERs for PTNS versus monotherapy were £10,604, and PTNS versus dual pharmacotherapy were £11,620 at 5 years. CONCLUSIONS PTNS for OAB patients provides quality of life improvement and ICERs that are below the threshold for UK cost-effectiveness. PTNS represents value for money but at incremental cost (more effective/more costly) compared to mono and dual pharmacotherapy. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e850 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Julie Jenks More articles by this author Eskinder Solomon More articles by this author Mahreen Pakzad More articles by this author Rizwan Hamid More articles by this author Tamsin Greenwell More articles by this author Jeremy Ockrim More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...