Kelly Laura, Shore Judith, Wright James, Patrick Craig, Holmes Hayden
York Health Economics Consortium, Enterprise House, Innovation Way University of York York UK.
Laborie Medical Technologies CORP Portsmouth New Hampshire USA.
BJUI Compass. 2023 Apr 10;4(4):430-436. doi: 10.1002/bco2.241. eCollection 2023 Jul.
We aim to conduct an economic evaluation of the Optilume urethral drug-coated balloon (DCB) compared with endoscopic management for the treatment of recurrent anterior male urethral stricture in England.
A cohort Markov model was developed to estimate the costs and savings to the NHS over a 5-year time horizon of adopting Optilume for the treatment of anterior urethral male stricture versus current endoscopic standard of care. A scenario analysis was conducted which compared Optilume to urethroplasty. Probabilistic and deterministic sensitivity analyses were performed to estimate the impact of uncertainties in model parameters.
When compared with current endoscopic standard of care Optilume resulted in an estimated cost saving of £2502 per patient if introduced in the NHS for the treatment of recurrent anterior male urethral stricture. In the scenario analysis, the use of Optilume compared with urethroplasty resulted in an estimated cost saving of £243. Results were robust to changes in individual input parameters as demonstrated in the deterministic sensitivity analyses, with the monthly probability of symptom recurrence associated with endoscopic management the only exception. Probabilistic sensitivity analysis results demonstrated that Optilume was cost saving in 93.4% of model iterations, when running 1000 iterations.
Our analysis suggests that the Optilume urethral DCB treatment can be a cost-saving alternative management option for the treatment of recurrent anterior male urethral stricture within the NHS in England.
我们旨在对Optilume尿道药物涂层球囊(DCB)与内镜治疗男性复发性前尿道狭窄进行经济学评估,研究在英国的情况。
建立队列马尔可夫模型,以估计在5年时间范围内,英国国家医疗服务体系(NHS)采用Optilume治疗男性前尿道狭窄相对于当前内镜标准治疗的成本和节约情况。进行了情景分析,将Optilume与尿道成形术进行比较。进行了概率性和确定性敏感性分析,以估计模型参数不确定性的影响。
与当前内镜标准治疗相比,如果在NHS中采用Optilume治疗男性复发性前尿道狭窄,估计每位患者可节省成本2502英镑。在情景分析中,与尿道成形术相比,使用Optilume估计可节省成本243英镑。如确定性敏感性分析所示,结果对单个输入参数的变化具有稳健性,唯一的例外是与内镜治疗相关的症状复发月度概率。概率性敏感性分析结果表明,在运行1000次迭代时,Optilume在93.4%的模型迭代中具有成本节约效果。
我们的分析表明,Optilume尿道DCB治疗对于英国NHS内男性复发性前尿道狭窄的治疗而言,可能是一种节约成本的替代管理选择。