Cost-Effectiveness Analysis of OnabotulinumtoxinA (BOTOX®) for the Management of Urinary Incontinence in Adults with Neurogenic Detrusor Overactivity: A UK Perspective
Objectives To evaluate the cost effectiveness of onabotulinumtoxinA (BOTOX ® , 200 units [200 U]) for the management of urinary incontinence (UI) in adults with neurogenic detrusor overactivity (NDO) due to subcervical spinal cord injury or multiple sclerosis that is not adequately managed with anti...
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| Veröffentlicht in: | PharmacoEconomics 2015-04, Vol.33 (4), p.381-393 |
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| creator | Hamid, Rizwan Loveman, Clara Millen, Jim Globe, Denise Corbell, Catherine Colayco, Danielle Stanisic, Sanja Gultyaev, Dmitry |
| description | Objectives
To evaluate the cost effectiveness of onabotulinumtoxinA (BOTOX
®
, 200 units [200 U]) for the management of urinary incontinence (UI) in adults with neurogenic detrusor overactivity (NDO) due to subcervical spinal cord injury or multiple sclerosis that is not adequately managed with anticholinergic drugs (ACHDs).
Perspective
UK National Health Service (NHS) perspective.
Methods
A Markov state-transition model was developed, which compared onabotulinumtoxinA + best supportive care (BSC) with BSC alone (comprising behavioural therapy and pads, alone or in combination with clean intermittent catheterization and possibly with ACHDs). Non-responders were eligible for invasive procedures. Health states were defined according to the reduction in UI episodes. Efficacy data and estimates of resource utilization were pooled from 468 patients on onabotulinumtoxinA in two phase III clinical trials. Drug costs (2013) and administration costs (NHS Reference Costs 2011–2012) were obtained from published sources. The time horizon of the model was 5 years, and costs and benefits were discounted at 3.5 %. Scenario, one-way and probabilistic sensitivity analyses (PSAs) were conducted to explore uncertainties around the assumptions.
Results
In the base case, treatment with onabotulinumtoxinA + BSC over 5 years was associated with an increase in costs of £1,689 and an increase in quality-adjusted life-years (QALYs) of 0.4, compared with BSC alone, resulting in an incremental cost-effectiveness ratio of £3,850 per QALY gained. Sensitivity analyses showed that utility values had the greatest influence on model results. PSA suggests that onabotulinumtoxinA + BSC had a 100 % probability of being cost effective at a willingness to pay of |
| doi_str_mv | 10.1007/s40273-014-0245-8 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4381108</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714597081</galeid><sourcerecordid>A714597081</sourcerecordid><originalsourceid>FETCH-LOGICAL-c607t-b6a430bbfe1a2bf5f92ce61b73bd7eb6a8614828a8e319824657385069620d393</originalsourceid><addsrcrecordid>eNp1UsFu1DAQjRCIlsIHcEGWuJRDiu0ktsOhUlgKVBSWQ1fiZjnZ8dZVYi-2s7B_xImP4Mtw2FJaBPLB1sybN_PGL8seE3xEMObPQ4kpL3JMyhzTssrFnWyfEF7nNMXv_nrjnLMa72UPQrjEGLOC0_vZHq0qykRJ97NvMxdifqI1dNFswEIIqLGq3wYTkNNoblXr4tgbOw7RfTW2QYcv5-fzTz--P0PaeRQvAL1XVq1gABunkoU3VvktOrWds9FYsB0gY1GzHPsY0BcTL9AHGL1bgTUdegXRjyExzTfg1TSFidsXqEGLd-gj-LDeTfYwu6dVH-DR1X2QLV6fnM_e5mfzN6ez5izvGOYxb5kqC9y2Goiira50TTtgpOVFu-SQsoKRUlChBBSkFrRkFS9EhVnNKF4WdXGQHe9412M7wLJLorzq5dqbIYmSThl5O2PNhVy5jSwLQQgWieDwisC7zyOEKAcTOuh7ZcGNQRLG6jI1xEWCPv0LeulGn7Y_oQTmjFFC_6BWqgdprHapbzeRyoaTsqo5FiShjv6BSmcJg0kfAdqk-K0CsivovAvBg77WSLCc7CV39pLJXnKyl5y0Pbm5nOuK335KALoDhJSyK_A3FP2X9SfbrNxc</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1680766212</pqid></control><display><type>article</type><title>Cost-Effectiveness Analysis of OnabotulinumtoxinA (BOTOX®) for the Management of Urinary Incontinence in Adults with Neurogenic Detrusor Overactivity: A UK Perspective</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Hamid, Rizwan ; Loveman, Clara ; Millen, Jim ; Globe, Denise ; Corbell, Catherine ; Colayco, Danielle ; Stanisic, Sanja ; Gultyaev, Dmitry</creator><creatorcontrib>Hamid, Rizwan ; Loveman, Clara ; Millen, Jim ; Globe, Denise ; Corbell, Catherine ; Colayco, Danielle ; Stanisic, Sanja ; Gultyaev, Dmitry</creatorcontrib><description>Objectives
To evaluate the cost effectiveness of onabotulinumtoxinA (BOTOX
®
, 200 units [200 U]) for the management of urinary incontinence (UI) in adults with neurogenic detrusor overactivity (NDO) due to subcervical spinal cord injury or multiple sclerosis that is not adequately managed with anticholinergic drugs (ACHDs).
Perspective
UK National Health Service (NHS) perspective.
Methods
A Markov state-transition model was developed, which compared onabotulinumtoxinA + best supportive care (BSC) with BSC alone (comprising behavioural therapy and pads, alone or in combination with clean intermittent catheterization and possibly with ACHDs). Non-responders were eligible for invasive procedures. Health states were defined according to the reduction in UI episodes. Efficacy data and estimates of resource utilization were pooled from 468 patients on onabotulinumtoxinA in two phase III clinical trials. Drug costs (2013) and administration costs (NHS Reference Costs 2011–2012) were obtained from published sources. The time horizon of the model was 5 years, and costs and benefits were discounted at 3.5 %. Scenario, one-way and probabilistic sensitivity analyses (PSAs) were conducted to explore uncertainties around the assumptions.
Results
In the base case, treatment with onabotulinumtoxinA + BSC over 5 years was associated with an increase in costs of £1,689 and an increase in quality-adjusted life-years (QALYs) of 0.4, compared with BSC alone, resulting in an incremental cost-effectiveness ratio of £3,850 per QALY gained. Sensitivity analyses showed that utility values had the greatest influence on model results. PSA suggests that onabotulinumtoxinA + BSC had a 100 % probability of being cost effective at a willingness to pay of <£20,000.
Conclusion
For adult patients with NDO who are not adequately managed with ACHDs, onabotulinumtoxinA + BSC appears to be a cost-effective use of resources in the UK NHS.</description><identifier>ISSN: 1170-7690</identifier><identifier>EISSN: 1179-2027</identifier><identifier>DOI: 10.1007/s40273-014-0245-8</identifier><identifier>PMID: 25526842</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Acetylcholine Release Inhibitors - administration & dosage ; Acetylcholine Release Inhibitors - economics ; Acetylcholine Release Inhibitors - therapeutic use ; Adult ; Adults ; Anticholinergics ; Behavior modification ; Bladder ; Bladder diseases ; Botulinum toxin ; Botulinum Toxins, Type A - administration & dosage ; Botulinum Toxins, Type A - economics ; Botulinum Toxins, Type A - therapeutic use ; Care and treatment ; Clinical medicine ; Clinical trials ; Complications and side effects ; Cost analysis ; Cost benefit analysis ; Dosage and administration ; Drug Costs ; Drugs ; Estimates ; Health Administration ; Health care expenditures ; Health Economics ; Health services ; Health technology assessment ; Humans ; Intubation ; Markov analysis ; Medical treatment ; Medicine ; Medicine & Public Health ; Methods ; Models, Economic ; Multiple sclerosis ; Multiple Sclerosis - complications ; Original ; Original Research Article ; Palliative care ; Patients ; Pharmacoeconomics and Health Outcomes ; Population ; Public Health ; Quality of life ; Quality of Life Research ; Quality-Adjusted Life Years ; Spinal cord injuries ; Spinal Cord Injuries - complications ; Studies ; United Kingdom ; Urinary Bladder, Neurogenic - complications ; Urinary Bladder, Neurogenic - drug therapy ; Urinary Bladder, Neurogenic - economics ; Urinary incontinence ; Urinary Incontinence - drug therapy ; Urinary Incontinence - economics ; Urinary Incontinence - etiology</subject><ispartof>PharmacoEconomics, 2015-04, Vol.33 (4), p.381-393</ispartof><rights>The Author(s) 2014</rights><rights>COPYRIGHT 2015 Springer</rights><rights>Copyright Springer Science & Business Media Apr 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c607t-b6a430bbfe1a2bf5f92ce61b73bd7eb6a8614828a8e319824657385069620d393</citedby><cites>FETCH-LOGICAL-c607t-b6a430bbfe1a2bf5f92ce61b73bd7eb6a8614828a8e319824657385069620d393</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40273-014-0245-8$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40273-014-0245-8$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25526842$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hamid, Rizwan</creatorcontrib><creatorcontrib>Loveman, Clara</creatorcontrib><creatorcontrib>Millen, Jim</creatorcontrib><creatorcontrib>Globe, Denise</creatorcontrib><creatorcontrib>Corbell, Catherine</creatorcontrib><creatorcontrib>Colayco, Danielle</creatorcontrib><creatorcontrib>Stanisic, Sanja</creatorcontrib><creatorcontrib>Gultyaev, Dmitry</creatorcontrib><title>Cost-Effectiveness Analysis of OnabotulinumtoxinA (BOTOX®) for the Management of Urinary Incontinence in Adults with Neurogenic Detrusor Overactivity: A UK Perspective</title><title>PharmacoEconomics</title><addtitle>PharmacoEconomics</addtitle><addtitle>Pharmacoeconomics</addtitle><description>Objectives
To evaluate the cost effectiveness of onabotulinumtoxinA (BOTOX
®
, 200 units [200 U]) for the management of urinary incontinence (UI) in adults with neurogenic detrusor overactivity (NDO) due to subcervical spinal cord injury or multiple sclerosis that is not adequately managed with anticholinergic drugs (ACHDs).
Perspective
UK National Health Service (NHS) perspective.
Methods
A Markov state-transition model was developed, which compared onabotulinumtoxinA + best supportive care (BSC) with BSC alone (comprising behavioural therapy and pads, alone or in combination with clean intermittent catheterization and possibly with ACHDs). Non-responders were eligible for invasive procedures. Health states were defined according to the reduction in UI episodes. Efficacy data and estimates of resource utilization were pooled from 468 patients on onabotulinumtoxinA in two phase III clinical trials. Drug costs (2013) and administration costs (NHS Reference Costs 2011–2012) were obtained from published sources. The time horizon of the model was 5 years, and costs and benefits were discounted at 3.5 %. Scenario, one-way and probabilistic sensitivity analyses (PSAs) were conducted to explore uncertainties around the assumptions.
Results
In the base case, treatment with onabotulinumtoxinA + BSC over 5 years was associated with an increase in costs of £1,689 and an increase in quality-adjusted life-years (QALYs) of 0.4, compared with BSC alone, resulting in an incremental cost-effectiveness ratio of £3,850 per QALY gained. Sensitivity analyses showed that utility values had the greatest influence on model results. PSA suggests that onabotulinumtoxinA + BSC had a 100 % probability of being cost effective at a willingness to pay of <£20,000.
Conclusion
For adult patients with NDO who are not adequately managed with ACHDs, onabotulinumtoxinA + BSC appears to be a cost-effective use of resources in the UK NHS.</description><subject>Acetylcholine Release Inhibitors - administration & dosage</subject><subject>Acetylcholine Release Inhibitors - economics</subject><subject>Acetylcholine Release Inhibitors - therapeutic use</subject><subject>Adult</subject><subject>Adults</subject><subject>Anticholinergics</subject><subject>Behavior modification</subject><subject>Bladder</subject><subject>Bladder diseases</subject><subject>Botulinum toxin</subject><subject>Botulinum Toxins, Type A - administration & dosage</subject><subject>Botulinum Toxins, Type A - economics</subject><subject>Botulinum Toxins, Type A - therapeutic use</subject><subject>Care and treatment</subject><subject>Clinical medicine</subject><subject>Clinical trials</subject><subject>Complications and side effects</subject><subject>Cost analysis</subject><subject>Cost benefit analysis</subject><subject>Dosage and administration</subject><subject>Drug Costs</subject><subject>Drugs</subject><subject>Estimates</subject><subject>Health Administration</subject><subject>Health care expenditures</subject><subject>Health Economics</subject><subject>Health services</subject><subject>Health technology assessment</subject><subject>Humans</subject><subject>Intubation</subject><subject>Markov analysis</subject><subject>Medical treatment</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methods</subject><subject>Models, Economic</subject><subject>Multiple sclerosis</subject><subject>Multiple Sclerosis - complications</subject><subject>Original</subject><subject>Original Research Article</subject><subject>Palliative care</subject><subject>Patients</subject><subject>Pharmacoeconomics and Health Outcomes</subject><subject>Population</subject><subject>Public Health</subject><subject>Quality of life</subject><subject>Quality of Life Research</subject><subject>Quality-Adjusted Life Years</subject><subject>Spinal cord injuries</subject><subject>Spinal Cord Injuries - complications</subject><subject>Studies</subject><subject>United Kingdom</subject><subject>Urinary Bladder, Neurogenic - complications</subject><subject>Urinary Bladder, Neurogenic - drug therapy</subject><subject>Urinary Bladder, Neurogenic - economics</subject><subject>Urinary incontinence</subject><subject>Urinary Incontinence - drug therapy</subject><subject>Urinary Incontinence - economics</subject><subject>Urinary Incontinence - etiology</subject><issn>1170-7690</issn><issn>1179-2027</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1UsFu1DAQjRCIlsIHcEGWuJRDiu0ktsOhUlgKVBSWQ1fiZjnZ8dZVYi-2s7B_xImP4Mtw2FJaBPLB1sybN_PGL8seE3xEMObPQ4kpL3JMyhzTssrFnWyfEF7nNMXv_nrjnLMa72UPQrjEGLOC0_vZHq0qykRJ97NvMxdifqI1dNFswEIIqLGq3wYTkNNoblXr4tgbOw7RfTW2QYcv5-fzTz--P0PaeRQvAL1XVq1gABunkoU3VvktOrWds9FYsB0gY1GzHPsY0BcTL9AHGL1bgTUdegXRjyExzTfg1TSFidsXqEGLd-gj-LDeTfYwu6dVH-DR1X2QLV6fnM_e5mfzN6ez5izvGOYxb5kqC9y2Goiira50TTtgpOVFu-SQsoKRUlChBBSkFrRkFS9EhVnNKF4WdXGQHe9412M7wLJLorzq5dqbIYmSThl5O2PNhVy5jSwLQQgWieDwisC7zyOEKAcTOuh7ZcGNQRLG6jI1xEWCPv0LeulGn7Y_oQTmjFFC_6BWqgdprHapbzeRyoaTsqo5FiShjv6BSmcJg0kfAdqk-K0CsivovAvBg77WSLCc7CV39pLJXnKyl5y0Pbm5nOuK335KALoDhJSyK_A3FP2X9SfbrNxc</recordid><startdate>20150401</startdate><enddate>20150401</enddate><creator>Hamid, Rizwan</creator><creator>Loveman, Clara</creator><creator>Millen, Jim</creator><creator>Globe, Denise</creator><creator>Corbell, Catherine</creator><creator>Colayco, Danielle</creator><creator>Stanisic, Sanja</creator><creator>Gultyaev, Dmitry</creator><general>Springer International Publishing</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0U~</scope><scope>1-H</scope><scope>3V.</scope><scope>4T-</scope><scope>7WY</scope><scope>7WZ</scope><scope>7X7</scope><scope>7XB</scope><scope>87Z</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FL</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BEZIV</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FRNLG</scope><scope>FYUFA</scope><scope>F~G</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K60</scope><scope>K6~</scope><scope>K9.</scope><scope>L.-</scope><scope>L.0</scope><scope>M0C</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>PQBIZ</scope><scope>PQBZA</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150401</creationdate><title>Cost-Effectiveness Analysis of OnabotulinumtoxinA (BOTOX®) for the Management of Urinary Incontinence in Adults with Neurogenic Detrusor Overactivity: A UK Perspective</title><author>Hamid, Rizwan ; Loveman, Clara ; Millen, Jim ; Globe, Denise ; Corbell, Catherine ; Colayco, Danielle ; Stanisic, Sanja ; Gultyaev, Dmitry</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c607t-b6a430bbfe1a2bf5f92ce61b73bd7eb6a8614828a8e319824657385069620d393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acetylcholine Release Inhibitors - administration & dosage</topic><topic>Acetylcholine Release Inhibitors - economics</topic><topic>Acetylcholine Release Inhibitors - therapeutic use</topic><topic>Adult</topic><topic>Adults</topic><topic>Anticholinergics</topic><topic>Behavior modification</topic><topic>Bladder</topic><topic>Bladder diseases</topic><topic>Botulinum toxin</topic><topic>Botulinum Toxins, Type A - administration & dosage</topic><topic>Botulinum Toxins, Type A - economics</topic><topic>Botulinum Toxins, Type A - therapeutic use</topic><topic>Care and treatment</topic><topic>Clinical medicine</topic><topic>Clinical trials</topic><topic>Complications and side effects</topic><topic>Cost analysis</topic><topic>Cost benefit analysis</topic><topic>Dosage and administration</topic><topic>Drug Costs</topic><topic>Drugs</topic><topic>Estimates</topic><topic>Health Administration</topic><topic>Health care expenditures</topic><topic>Health Economics</topic><topic>Health services</topic><topic>Health technology assessment</topic><topic>Humans</topic><topic>Intubation</topic><topic>Markov analysis</topic><topic>Medical treatment</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Methods</topic><topic>Models, Economic</topic><topic>Multiple sclerosis</topic><topic>Multiple Sclerosis - complications</topic><topic>Original</topic><topic>Original Research Article</topic><topic>Palliative care</topic><topic>Patients</topic><topic>Pharmacoeconomics and Health Outcomes</topic><topic>Population</topic><topic>Public Health</topic><topic>Quality of life</topic><topic>Quality of Life Research</topic><topic>Quality-Adjusted Life Years</topic><topic>Spinal cord injuries</topic><topic>Spinal Cord Injuries - complications</topic><topic>Studies</topic><topic>United Kingdom</topic><topic>Urinary Bladder, Neurogenic - complications</topic><topic>Urinary Bladder, Neurogenic - drug therapy</topic><topic>Urinary Bladder, Neurogenic - economics</topic><topic>Urinary incontinence</topic><topic>Urinary Incontinence - drug therapy</topic><topic>Urinary Incontinence - economics</topic><topic>Urinary Incontinence - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hamid, Rizwan</creatorcontrib><creatorcontrib>Loveman, Clara</creatorcontrib><creatorcontrib>Millen, Jim</creatorcontrib><creatorcontrib>Globe, Denise</creatorcontrib><creatorcontrib>Corbell, Catherine</creatorcontrib><creatorcontrib>Colayco, Danielle</creatorcontrib><creatorcontrib>Stanisic, Sanja</creatorcontrib><creatorcontrib>Gultyaev, Dmitry</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Global News & ABI/Inform Professional</collection><collection>Trade PRO</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>ABI/INFORM Collection</collection><collection>ABI/INFORM Global (PDF only)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ABI/INFORM Global (Alumni Edition)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ABI/INFORM Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Business Premium Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Business Premium Collection (Alumni)</collection><collection>Health Research Premium Collection</collection><collection>ABI/INFORM Global (Corporate)</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Business Collection (Alumni Edition)</collection><collection>ProQuest Business Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ABI/INFORM Professional Advanced</collection><collection>ABI/INFORM Professional Standard</collection><collection>ABI/INFORM Global</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>ProQuest One Business</collection><collection>ProQuest One Business (Alumni)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>PharmacoEconomics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hamid, Rizwan</au><au>Loveman, Clara</au><au>Millen, Jim</au><au>Globe, Denise</au><au>Corbell, Catherine</au><au>Colayco, Danielle</au><au>Stanisic, Sanja</au><au>Gultyaev, Dmitry</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost-Effectiveness Analysis of OnabotulinumtoxinA (BOTOX®) for the Management of Urinary Incontinence in Adults with Neurogenic Detrusor Overactivity: A UK Perspective</atitle><jtitle>PharmacoEconomics</jtitle><stitle>PharmacoEconomics</stitle><addtitle>Pharmacoeconomics</addtitle><date>2015-04-01</date><risdate>2015</risdate><volume>33</volume><issue>4</issue><spage>381</spage><epage>393</epage><pages>381-393</pages><issn>1170-7690</issn><eissn>1179-2027</eissn><abstract>Objectives
To evaluate the cost effectiveness of onabotulinumtoxinA (BOTOX
®
, 200 units [200 U]) for the management of urinary incontinence (UI) in adults with neurogenic detrusor overactivity (NDO) due to subcervical spinal cord injury or multiple sclerosis that is not adequately managed with anticholinergic drugs (ACHDs).
Perspective
UK National Health Service (NHS) perspective.
Methods
A Markov state-transition model was developed, which compared onabotulinumtoxinA + best supportive care (BSC) with BSC alone (comprising behavioural therapy and pads, alone or in combination with clean intermittent catheterization and possibly with ACHDs). Non-responders were eligible for invasive procedures. Health states were defined according to the reduction in UI episodes. Efficacy data and estimates of resource utilization were pooled from 468 patients on onabotulinumtoxinA in two phase III clinical trials. Drug costs (2013) and administration costs (NHS Reference Costs 2011–2012) were obtained from published sources. The time horizon of the model was 5 years, and costs and benefits were discounted at 3.5 %. Scenario, one-way and probabilistic sensitivity analyses (PSAs) were conducted to explore uncertainties around the assumptions.
Results
In the base case, treatment with onabotulinumtoxinA + BSC over 5 years was associated with an increase in costs of £1,689 and an increase in quality-adjusted life-years (QALYs) of 0.4, compared with BSC alone, resulting in an incremental cost-effectiveness ratio of £3,850 per QALY gained. Sensitivity analyses showed that utility values had the greatest influence on model results. PSA suggests that onabotulinumtoxinA + BSC had a 100 % probability of being cost effective at a willingness to pay of <£20,000.
Conclusion
For adult patients with NDO who are not adequately managed with ACHDs, onabotulinumtoxinA + BSC appears to be a cost-effective use of resources in the UK NHS.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>25526842</pmid><doi>10.1007/s40273-014-0245-8</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1170-7690 |
| ispartof | PharmacoEconomics, 2015-04, Vol.33 (4), p.381-393 |
| issn | 1170-7690 1179-2027 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4381108 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Acetylcholine Release Inhibitors - administration & dosage Acetylcholine Release Inhibitors - economics Acetylcholine Release Inhibitors - therapeutic use Adult Adults Anticholinergics Behavior modification Bladder Bladder diseases Botulinum toxin Botulinum Toxins, Type A - administration & dosage Botulinum Toxins, Type A - economics Botulinum Toxins, Type A - therapeutic use Care and treatment Clinical medicine Clinical trials Complications and side effects Cost analysis Cost benefit analysis Dosage and administration Drug Costs Drugs Estimates Health Administration Health care expenditures Health Economics Health services Health technology assessment Humans Intubation Markov analysis Medical treatment Medicine Medicine & Public Health Methods Models, Economic Multiple sclerosis Multiple Sclerosis - complications Original Original Research Article Palliative care Patients Pharmacoeconomics and Health Outcomes Population Public Health Quality of life Quality of Life Research Quality-Adjusted Life Years Spinal cord injuries Spinal Cord Injuries - complications Studies United Kingdom Urinary Bladder, Neurogenic - complications Urinary Bladder, Neurogenic - drug therapy Urinary Bladder, Neurogenic - economics Urinary incontinence Urinary Incontinence - drug therapy Urinary Incontinence - economics Urinary Incontinence - etiology |
| title | Cost-Effectiveness Analysis of OnabotulinumtoxinA (BOTOX®) for the Management of Urinary Incontinence in Adults with Neurogenic Detrusor Overactivity: A UK Perspective |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T20%3A28%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cost-Effectiveness%20Analysis%20of%20OnabotulinumtoxinA%20(BOTOX%C2%AE)%20for%20the%20Management%20of%20Urinary%20Incontinence%20in%20Adults%20with%20Neurogenic%20Detrusor%20Overactivity:%20A%20UK%20Perspective&rft.jtitle=PharmacoEconomics&rft.au=Hamid,%20Rizwan&rft.date=2015-04-01&rft.volume=33&rft.issue=4&rft.spage=381&rft.epage=393&rft.pages=381-393&rft.issn=1170-7690&rft.eissn=1179-2027&rft_id=info:doi/10.1007/s40273-014-0245-8&rft_dat=%3Cgale_pubme%3EA714597081%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1680766212&rft_id=info:pmid/25526842&rft_galeid=A714597081&rfr_iscdi=true |