Cost Effectiveness of Sacral Neuromodulation and OnabotulinumtoxinA in Managing Refractory Idiopathic Overactive Bladder

Urology. 2021 Mar:149:1-10. doi: 10.1016/j.urology.2020.11.018. Epub 2020 Nov 20.

Abstract

Little information from clinical and modelled studies are available on cost effectiveness of OnabotulinumtoxinA and SNM for the treatment of idiopathic overactive bladder. We aimed to summarize the evidence in this regard from different healthcare systems. Seven studies from 5 countries were reviewed. Some modelled studies with a 10-year time frame showed that sacral neuromodulation became dominant long-term; others suggested OnabotulinumtoxinA was more cost effective at <5 years. There was considerable heterogeneity in the base case/sensitivity analysis and statistical modelling among the studies. Clinical studies with longer term follow-up will help determine cost effectiveness more accurately.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Botulinum Toxins, Type A / economics*
  • Botulinum Toxins, Type A / therapeutic use
  • Cost-Benefit Analysis
  • Electric Stimulation Therapy / economics*
  • Electric Stimulation Therapy / trends
  • Humans
  • Lumbosacral Plexus*
  • Markov Chains
  • Monte Carlo Method
  • Neuromuscular Agents / economics*
  • Neuromuscular Agents / therapeutic use
  • Quality-Adjusted Life Years
  • Time Factors
  • Urinary Bladder, Overactive / drug therapy
  • Urinary Bladder, Overactive / therapy*

Substances

  • Neuromuscular Agents
  • Botulinum Toxins, Type A
  • onabotulinum toxin A