Conflict of interest: none.
Original Clinical Article
Cost-effectiveness of an Internet-based treatment program for stress urinary incontinence
Article first published online: 17 DEC 2013
© 2013 The Authors. Neurourology and Urodynamics Published by Wiley Periodicals, Inc.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Neurourology and Urodynamics
How to Cite
Sjöström, M., Umefjord, G., Lindholm, L. and Samuelsson, E. (2013), Cost-effectiveness of an Internet-based treatment program for stress urinary incontinence. Neurourol. Urodyn.. doi: 10.1002/nau.22540
Christopher Chapple led the peer-review process as the Associate Editor responsible for the paper.
- Article first published online: 17 DEC 2013
- Manuscript Accepted: 11 NOV 2013
- Manuscript Received: 3 JUL 2013
- Swedish Council for Working Life and Social Research
- Jämtland County Council
- Västerbotten County Council (ALF)
- Visare Norr, Northern County Councils, Sweden
- pelvic floor muscle training;
- stress urinary incontinence
To perform a deterministic cost-utility analysis, from a 1-year societal perspective, of two treatment programs for stress urinary incontinence (SUI) without face-to-face contact: one Internet-based and one sent by post. The treatments were compared with each other and with no treatment.
We performed this economic evaluation alongside a randomized controlled trial. The study included 250 women aged 18–70, with SUI ≥ 1 time/week, who were randomized to 3 months of pelvic floor muscle training via either an Internet-based program including e-mail support from an urotherapist (n = 124) or a program sent by post (n = 126). Recruitment was web-based, and participants were self-assessed with validated questionnaires and 2-day bladder diaries, supplemented by a telephone interview with a urotherapist. Treatment costs were continuously registered. Data on participants' time for training, incontinence aids, and laundry were collected at baseline, 4 months, and 1 year. We also measured quality of life with the condition-specific questionnaire ICIQ-LUTSqol, and calculated the quality-adjusted life-years (QALYs) gained. Baseline data remained unchanged for the no treatment option. Sensitivity analysis was performed.
Compared to the postal program, the extra cost per QALY for the Internet-based program ranged from 200€ to 7,253€, indicating greater QALY-gains at similar or slightly higher costs. Compared to no treatment, the extra cost per QALY for the Internet-based program ranged from 10,022€ to 38,921€, indicating greater QALY-gains at higher, but probably acceptable costs.
An Internet-based treatment for SUI is a new, cost-effective treatment alternative. Neurourol. Urodynam. 9999:1–7, 2013. © 2013 The Authors. Neurourology and Urodynamics Published by Wiley Periodicals, Inc.