title: Cost-effectiveness analysis of sacral nerve stimulation as treatment for severe irritable bowel syndrome.
abstract: OBJECTIVE
  Early results from sacral nerve stimulation (SNS) for severe irritable bowel syndrome (IBS) are promising but estimates of cost-effectiveness are lacking. Our object was to perform a cost-effectiveness analysis for SNS as an alternative to no treatment of IBS.
  
  
  METHODS
  This retrospective analysis was based on the results from a randomized controlled crossover study with a cost-utility analysis performed on patient-level data and modelling of censored data over a projected period of time of up to 20 years. The analysis was conducted on an intention-to-treat approach. For estimation of the uncertainty of the incremental cost-effectiveness ratio a bias corrected bootstrap analysis was performed.
  
  
  RESULTS
  Cost-effectiveness was not reached for 4 years after permanent implantation (£31 270 per quality-adjusted life years), which was the upper limit for patient follow-up, but our data imply a cost-effectiveness from a 7-year perspective onwards.
  
  
  CONCLUSIONS
  The study indicates the SNS treatment for IBS is cost effective from a 7-year perspective onwards.
authors.affiliation: Danish Center for Health Care Improvement, Aalborg University, Aalborg, Denmark.
authors.forename: L S
authors.initials: LS
authors.lastname: Tipsmark
authors.affiliation: Neurogastroenterology Unit, Department of Hepatology and Gastroenterology V, Aarhus University Hospital, Aarhus, Denmark.|Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Fassov
authors.affiliation: Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Lundby
authors.affiliation: Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Laurberg
authors.affiliation: Danish Center for Health Care Improvement, Aalborg University, Aalborg, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Ehlers
authors.affiliation: Neurogastroenterology Unit, Department of Hepatology and Gastroenterology V, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Krogh
mesh_terms: D003362:Cost-Benefit Analysis; D018592:Cross-Over Studies; D003718:Denmark; D004599:Electric Stimulation Therapy / Q000191:economics*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000191:economics / Q000628:therapy*; D008160:Lumbosacral Plexus; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Cost-utility analysis; cost-effectiveness; irritable bowel syndrome; sacral nerve stimulation