title: [Medico-economic evaluation of urological cares of spinal cord injured patients: A review].
abstract: BACKGROUND
  To provide an overview of the urological management of spinal cord injured patients based on an economic analysis.
  
  
  METHODS
  A literature search from January 1994 to December 2014 was performed using Medline and Embase database using the following keywords: cost-effectiveness; cost-benefit; cost-utility; spinal cord injury; neurogenic bladder; intermittent catheterization; antimuscarinics; botulinum toxin; sacral neuromodulation; tibial nerve; Brindley; sphincterotomy. The tool used for comparison was the QALY ("quality adjusted life years"); an indicator between 0 and 1 allowing the comparison between two medical treatments using cost per QALY.
  
  
  RESULTS
  Solifenacin (5 to 10mg) is the most cost-effective treatment with an incremental cost-effectiveness ratio (ICER) of 19,893 €/QALY compared to trospium 40mg, of 16,657 €/QALY compared to trospium 60mg, of 12,309 £/QALY compared to oxybutinin. Botulinum toxin A is also cost-effective with an ICER of 24,720 $/QALY compared to best supportive cares for anticholinergic-refractory neurogenic detrusor overactivity.
  
  
  CONCLUSIONS
  Solifenacin and botulinum toxin A appears to be the most cost-effective treatments for spinal injured urological cares. There is a pressing need to both increase and improve data collection and research on spinal cord injury.
authors.affiliation: Service d'urologie et de transplantation rénale, hôpital universitaire la Pitié-Salpêtrière, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, Assistance publique-Hôpitaux de Paris, 75013 Paris, France. Electronic address: c.guillot.tantay@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Guillot-Tantay
authors.affiliation: Service d'urologie et de transplantation rénale, hôpital universitaire la Pitié-Salpêtrière, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Chartier-Kastler
authors.affiliation: Service d'urologie et de transplantation rénale, hôpital universitaire la Pitié-Salpêtrière, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.
authors.forename: Q
authors.initials: Q
authors.lastname: Manach
authors.affiliation: Service d'urologie et de transplantation rénale, hôpital universitaire la Pitié-Salpêtrière, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.
authors.forename: M-A
authors.initials: MA
authors.lastname: Perrouin-Verbe
authors.affiliation: Service de médecine physique et réadaptation, hôpital Raymond-Poincaré, Assistance publique-Hôpitaux de Paris, 92380 Garches, France.
authors.forename: P
authors.initials: P
authors.lastname: Denys
authors.affiliation: Service d'urologie et de transplantation rénale, hôpital universitaire la Pitié-Salpêtrière, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Phé
mesh_terms: D003362:Cost-Benefit Analysis; D006801:Humans; D013119:Spinal Cord Injuries / Q000150:complications*; D001750:Urinary Bladder, Neurogenic / Q000191:economics* / Q000209:etiology / Q000628:therapy*
keywords: Blessé médullaire; Cost-benefit; Cost-effectiveness; Cost-utility; Coûts-bénéfice; Coûts-efficacité; Coûts-utilité; Spinal cord injury