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- Title
Cost-Effectiveness Analysis of Long-Term Intermittent Self-Catheterization with Hydrophilic-Coated and Uncoated Catheters in Patients with Spinal Cord Injury in Japan.
- Authors
WATANABE, Toyohiko; YAMAMOTO, Shingo; GOTOH, Momokazu; SAITOH, Tadanori; YOKOYAMA, Osamu; MURATA, Tatsunori; TAKEDA, Masayuki
- Abstract
Objectives To evaluate the cost effectiveness of disposable, hydrophilic-coated catheters in Japan. Methods A Markov decision model previously applied in a European study was used to evaluate the cost effectiveness of intermittent self-catheterization ( ISC) with hydrophilic-coated catheters in Japanese spinal cord injury ( SCI) patients suffering from chronic urinary retention from a lifetime perspective. To adjust the model to a Japanese setting, relevant Japanese data regarding the baseline risk of urinary tract infection ( UTI), the average age at onset of SCI, costs, and general mortality were extracted from published literature, national statistics, or the opinions of Japanese experts. The direct medical costs, quality-adjusted life years ( QALYs) and life years gained ( LYG) were calculated from the payers' perspective. An annual discount rate of 2% was applied to both the costs and the effects. Results The incremental cost of hydrophilic-coated catheters was 1 279 886 yen ( US$ 10 578 at an exchange rate of US$ 1 = 121 yen) per SCI patient, but they yielded an additional 0.334 QALYs and 0.781 LYG compared with uncoated catheters. The incremental cost-effectiveness ratio ( ICER) of hydrophilic-coated catheters vs. uncoated catheters was 3 826 351 yen/ QALY ( US$ 31 623/ QALY) gained and 1 639 562 yen/ LYG ( US$ 13 550/ LYG). Conclusions The ICER of 3.8 million yen ( US$ 31 405) falls well within the Japanese societal willingness to pay per QALY gained; therefore, hydrophilic-coated catheters can be considered highly cost-effective in Japan compared with uncoated catheters. However, because of the lack of relevant studies, a number of key parameters could not be based on Japanese data, and further research among people with SCI in Japan is recommended.
- Subjects
SPINAL cord injuries; INTERMITTENT urinary catheterization; COST effectiveness; MARKOV processes; QUALITY-adjusted life years
- Publication
LUTS, 2017, Vol 9, Issue 3, p142
- ISSN
1757-5664
- Publication type
Article
- DOI
10.1111/luts.12122