Cost-Effectiveness of Duloxetine: The Stress Urinary Incontinence Treatment (SUIT) Study

TY - JOUR

T1 - Cost-Effectiveness of Duloxetine: The Stress Urinary Incontinence Treatment (SUIT) Study

AU - Mihaylova, Borislava

AU - Pitman, Richard

AU - Tincello, Douglas

AU - van der Vaart, Huub

AU - Tunn, Ralf

AU - Timlin, Louise

AU - Quail, Deborah

AU - Johns, Adam

AU - Sculpher, Mark

PY - 2010/7

Y1 - 2010/7

N2 - Objective:To assess the cost-effectiveness of duloxetine compared with conservative therapy in women with stress urinary incontinence (SUI).Methods:Cost and outcome data were taken from the Stress Urinary Incontinence Treatment (SUIT) study, a 12-month, prospective, observational, naturalistic, multicenter, multicountry study. Costs were assessed in UK pound and outcomes in quality adjusted life years using responses to the EuroQol (EQ-5D); numbers of urine leaks were also estimated. Potential selection bias was countered using multivariate regression and propensity score analysis.Results:Duloxetine alone, duloxetine in combination with conservative treatment, and conservative treatment alone were associated with roughly two fewer leaks per week compared with no treatment. Duloxetine alone and with conservative treatment for SUI were associated with incremental quality-adjusted life-years (QALYs) of about 0.03 over a year compared with no treatment or with conservative treatment alone. Conservative treatment alone did not show an effect on QALYs. None of the interventions appeared to have marked impacts on costs over a year. Depending on the form of matching, duloxetine either dominated or had an incremental cost-effectiveness ratio (ICER) below 900 pound per QALY gained compared with no treatment and with conservative treatment alone. Duloxetine plus conservative therapy had an ICER below 5500 pound compared with no treatment or conservative treatment alone. Duloxetine compared with duloxetine plus conservative therapy showed similar outcomes but an additional cost for the combined intervention.Conclusions:Although the limitations of the use of SUIT's observational data for this purpose need to be acknowledged, the study suggests that initiating duloxetine therapy in SUI is a cost-effective treatment alternative.

AB - Objective:To assess the cost-effectiveness of duloxetine compared with conservative therapy in women with stress urinary incontinence (SUI).Methods:Cost and outcome data were taken from the Stress Urinary Incontinence Treatment (SUIT) study, a 12-month, prospective, observational, naturalistic, multicenter, multicountry study. Costs were assessed in UK pound and outcomes in quality adjusted life years using responses to the EuroQol (EQ-5D); numbers of urine leaks were also estimated. Potential selection bias was countered using multivariate regression and propensity score analysis.Results:Duloxetine alone, duloxetine in combination with conservative treatment, and conservative treatment alone were associated with roughly two fewer leaks per week compared with no treatment. Duloxetine alone and with conservative treatment for SUI were associated with incremental quality-adjusted life-years (QALYs) of about 0.03 over a year compared with no treatment or with conservative treatment alone. Conservative treatment alone did not show an effect on QALYs. None of the interventions appeared to have marked impacts on costs over a year. Depending on the form of matching, duloxetine either dominated or had an incremental cost-effectiveness ratio (ICER) below 900 pound per QALY gained compared with no treatment and with conservative treatment alone. Duloxetine plus conservative therapy had an ICER below 5500 pound compared with no treatment or conservative treatment alone. Duloxetine compared with duloxetine plus conservative therapy showed similar outcomes but an additional cost for the combined intervention.Conclusions:Although the limitations of the use of SUIT's observational data for this purpose need to be acknowledged, the study suggests that initiating duloxetine therapy in SUI is a cost-effective treatment alternative.

KW - cost-effectiveness analysis

KW - EQ-5D

KW - observational study

KW - outcomes research

KW - women's health

KW - ECONOMIC-EVALUATION

KW - PROPENSITY SCORE

KW - WOMEN

KW - PREVALENCE

KW - COMMUNITY

KW - POPULATION

KW - DEFINITION

KW - OUTCOMES

UR - http://www.scopus.com/inward/record.url?scp=77955408795&partnerID=8YFLogxK

U2 - 10.1111/j.1524-4733.2010.00729.x

DO - 10.1111/j.1524-4733.2010.00729.x

M3 - Article

SN - 1098-3015

VL - 13

SP - 565

EP - 572

JO - Value in Health

JF - Value in Health

IS - 5

ER -