Treatment costs of bladder pain syndrome/interstitial cystitis in Austria: a pharmacoeconomic approach following current guidelines.
BACKGROUND
Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease with a significant impact on quality of life. A broad range of therapies are used to treat this condition, and patients are often excluded from receiving more expensive and more effective therapies because of cost issues.


OBJECTIVE
The objective of this study was to assess the mid- and long-term costs (over 1, 5 and 10 years) of various therapies for BPS/IC.


METHODS
Costs in an open-access health system (Austria) for three BPS/IC-specific therapies (intravesical hyaluronan, pentosanpolysulfate and amitriptyline), taken from the American Urological Association guidelines, were evaluated and compared with those of non-specific symptomatic therapies. Response rates for the different therapies were taken from peer-reviewed publications and used to define the need for therapy maintenance with regard to symptom improvement.


RESULTS
Despite the highest initial costs, the reduced need for further therapy in patients with long-term symptom remission after hyaluronan therapy resulted in the lowest total treatment costs at all three timepoints. Hyaluronan was cost saving against all alternatives in standard assumptions and in all sensitivity analyses. As a limitation, treatment costs in this study are specific for Austria. However, the template used for calculation of treatment costs can be transferred to all countries by inserting local prices.


CONCLUSIONS
Disease-specific therapies with high remission rates result in significantly lower long-term costs in BPS/IC. Non-specific symptomatic therapies are most expensive. Long-term cost effectiveness is crucial in the treatment of chronic diseases to limit expenses in individual healthcare systems.
Department of Urology, Landesklinikum Baden-Mödling, Wimmergasse 19, 2500, Baden, Austria, claus.riedl@baden.lknoe.at.
Claus
C
Riedl
Paul
P
Engelhardt
Bernhard
B
Schwarz
D000639:Amitriptyline / Q000191:economics* / Q000627:therapeutic use; D001317:Austria / Q000453:epidemiology; D018856:Cystitis, Interstitial / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D017850:Economics, Pharmaceutical / Q000639:trends; D017048:Health Care Costs / Q000639:trends; D006801:Humans; D006820:Hyaluronic Acid / Q000191:economics* / Q000627:therapeutic use; D010426:Pentosan Sulfuric Polyester / Q000191:economics* / Q000627:therapeutic use; D017410:Practice Guidelines as Topic / Q000592:standards
D000639:Amitriptyline; D010426:Pentosan Sulfuric Polyester; D006820:Hyaluronic Acid