Tags

Type your tag names separated by a space and hit enter

Is Burch colposuspension ever cost-effective compared with tension-free vaginal tape for stress incontinence?
Am J Obstet Gynecol. 2007 Jul; 197(1):62.e1-5.AJ

Abstract

OBJECTIVE

This study was undertaken to evaluate the cost-effectiveness of Burch colposuspension compared with tension-free vaginal tape.

STUDY DESIGN

A Markov decision model was developed to compare costs (2005 US dollars) and effectiveness (quality-adjusted life years) of Burch and tension-free vaginal tape for stress urinary incontinence over 10 years from a health care system perspective. After surgery, outcomes included cure, persistent stress urinary incontinence followed by second surgery, and persistent stress urinary incontinence and mesh erosion after tension-free vaginal tape. An incremental cost-effectiveness ratio of less than $50,000 per quality-adjusted life year was considered cost-effective.

RESULTS

For the base-case, the Burch strategy cost more than tension-free vaginal tape ($9320 vs $8081), but was slightly more effective (7.260 vs 7.248 quality-adjusted life years). The incremental cost-effectiveness ratio was $98,755 per quality-adjusted life year. The incremental cost-effectiveness ratio was less than $50,000 per quality-adjusted life year when the relative risk of cure after Burch to tension-free vaginal tape was greater than 1.09.

CONCLUSION

Burch colposuspension was not cost-effective compared with tension-free vaginal tape. However, if the tension-free vaginal tape failure rate was to increase over time, Burch may become cost-effective.

Links

Publisher Full Text
Aggregator Full Text
Aggregator Full Text

Authors+Show Affiliations

Wu JM
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Visco AG
No affiliation info available
Weidner AC
No affiliation info available
Myers ER
No affiliation info available

MeSH

Cost-Benefit AnalysisFemaleHealth Care CostsHumansMiddle AgedQuality-Adjusted Life YearsSuburethral SlingsSurgical MeshTreatment OutcomeUrinary Incontinence, StressUrogenital Surgical Procedures

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17618760

Citation

Wu, Jennifer M., et al. "Is Burch Colposuspension Ever Cost-effective Compared With Tension-free Vaginal Tape for Stress Incontinence?" American Journal of Obstetrics and Gynecology, vol. 197, no. 1, 2007, pp. 62.e1-5.
Wu JM, Visco AG, Weidner AC, et al. Is Burch colposuspension ever cost-effective compared with tension-free vaginal tape for stress incontinence? Am J Obstet Gynecol. 2007;197(1):62.e1-5.
Wu, J. M., Visco, A. G., Weidner, A. C., & Myers, E. R. (2007). Is Burch colposuspension ever cost-effective compared with tension-free vaginal tape for stress incontinence? American Journal of Obstetrics and Gynecology, 197(1), e1-5.
Wu JM, et al. Is Burch Colposuspension Ever Cost-effective Compared With Tension-free Vaginal Tape for Stress Incontinence. Am J Obstet Gynecol. 2007;197(1):62.e1-5. PubMed PMID: 17618760.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is Burch colposuspension ever cost-effective compared with tension-free vaginal tape for stress incontinence? AU - Wu,Jennifer M, AU - Visco,Anthony G, AU - Weidner,Alison C, AU - Myers,Evan R, PY - 2006/07/13/received PY - 2007/01/05/revised PY - 2007/02/26/accepted PY - 2007/7/10/pubmed PY - 2007/9/7/medline PY - 2007/7/10/entrez SP - 62.e1 EP - 5 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 197 IS - 1 N2 - OBJECTIVE: This study was undertaken to evaluate the cost-effectiveness of Burch colposuspension compared with tension-free vaginal tape. STUDY DESIGN: A Markov decision model was developed to compare costs (2005 US dollars) and effectiveness (quality-adjusted life years) of Burch and tension-free vaginal tape for stress urinary incontinence over 10 years from a health care system perspective. After surgery, outcomes included cure, persistent stress urinary incontinence followed by second surgery, and persistent stress urinary incontinence and mesh erosion after tension-free vaginal tape. An incremental cost-effectiveness ratio of less than $50,000 per quality-adjusted life year was considered cost-effective. RESULTS: For the base-case, the Burch strategy cost more than tension-free vaginal tape ($9320 vs $8081), but was slightly more effective (7.260 vs 7.248 quality-adjusted life years). The incremental cost-effectiveness ratio was $98,755 per quality-adjusted life year. The incremental cost-effectiveness ratio was less than $50,000 per quality-adjusted life year when the relative risk of cure after Burch to tension-free vaginal tape was greater than 1.09. CONCLUSION: Burch colposuspension was not cost-effective compared with tension-free vaginal tape. However, if the tension-free vaginal tape failure rate was to increase over time, Burch may become cost-effective. SN - 1097-6868 UR - https://www.unboundmedicine.com/medline/citation/17618760/Is_Burch_colposuspension_ever_cost_effective_compared_with_tension_free_vaginal_tape_for_stress_incontinence L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(07)00276-1 DB - PRIME DP - Unbound Medicine ER -