title: A cost-effectiveness analysis of long-term intermittent catheterisation with hydrophilic and uncoated catheters.
abstract: METHODS
  Cost-effectiveness analysisObjective:To establish a model to investigate the cost effectiveness for people with spinal cord injury (SCI), from a lifetime perspective, for the usage of two different single-use catheter designs: hydrophilic-coated (HC) and uncoated (UC). The model includes the long-term sequelae of impaired renal function and urinary tract infection (UTI).
  
  
  METHODS
  Analysis based on a UK perspective.
  
  
  METHODS
  A probabilistic Markov decision model was constructed, to compare lifetime costs and quality-adjusted life years, taking renal and UTI health states into consideration, as well as other catheter-related events. UTI event rates for the primary data set were based on data from hospital settings to ensure controlled and accurate reporting. A sensitivity analysis was applied to evaluate best- and worst-case scenarios.
  
  
  RESULTS
  The model predicts that a 36-year-old SCI patient with chronic urinary retention will live an additional 1.4 years if using HC catheters compared with UC catheters, at an incremental cost of £2100. Moreover, the lifetime number of UTI events will be reduced by 16%. All best- and worst-case estimates were within the UK threshold of being cost effective.
  
  
  CONCLUSIONS
  The use of HC catheters for intermittent catheterisation in SCI patients is highly cost effective. The outcome is consistent irrespective of whether UTI data are collected in hospital or community settings.
authors.affiliation: ICON Health Economics & Epidemiology, Oxford, UK.
authors.forename: J F
authors.initials: JF
authors.lastname: Clark
authors.affiliation: ICON Health Economics & Epidemiology, Oxford, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Mealing
authors.affiliation: ICON Health Economics & Epidemiology, Oxford, UK.
authors.forename: D A
authors.initials: DA
authors.lastname: Scott
authors.affiliation: Shriners Hospitals for Children, Chicago, IL, USA.
authors.forename: L C
authors.initials: LC
authors.lastname: Vogel
authors.affiliation: Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Krassioukov
authors.affiliation: Unità Spinale Unipolare, Azienda Ospedale Niguarda Cà Granda, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Spinelli
authors.affiliation: Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Bagi
authors.affiliation: University of Antwerp and University Hospital Antwerp, Antwerp, Belgium.
authors.forename: J-J
authors.initials: JJ
authors.lastname: Wyndaele
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D066264:Datasets as Topic / Q000706:statistics & numerical data; D004867:Equipment Design / Q000191:economics; D005260:Female; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D013119:Spinal Cord Injuries / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006113:United Kingdom; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000191:economics*; D014552:Urinary Tract Infections / Q000191:economics / Q000209:etiology / Q000628:therapy; D055815:Young Adult