Conflict of interest: none.
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
Volume 34, Issue 3, pages 244–250, March 2015
How to Cite
Sjöström, M., Umefjord, G., Lindholm, L. and Samuelsson, E. (2015), Cost-effectiveness of an Internet-based treatment program for stress urinary incontinence. Neurourol. Urodyn., 34: 244–250. doi: 10.1002/nau.22540
Christopher Chapple led the peer-review process as the Associate Editor responsible for the paper.
- Issue published online: 12 MAR 2015
- 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. 34:244–250, 2015. © 2013 The Authors. Neurourology and Urodynamics published by Wiley Periodicals, Inc.