Cost-Effectiveness of 2 Models of Pessary Care for Pelvic Organ Prolapse: Findings From the TOPSY Randomized Controlled Trial.
Value Health
; 27(7): 889-896, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38492924
ABSTRACT
OBJECTIVES:
Pelvic organ prolapse is the descent of one or more reproductive organs from their normal position, causing associated negative symptoms. One conservative treatment option is pessary management. This study aimed to to investigate the cost-effectiveness of pessary self-management (SM) when compared with clinic-based care (CBC). A decision analytic model was developed to extend the economic evaluation.METHODS:
A randomized controlled trial with health economic evaluation. The SM group received a 30-minute SM teaching session, information leaflet, 2-week follow-up call, and a local helpline number. The CBC group received routine outpatient pessary appointments, determined by usual practice. The primary outcome for the cost-effectiveness analysis was incremental cost per quality-adjusted life year (QALY), 18 months post-randomization. Uncertainty was handled using nonparametric bootstrap analysis. In addition, a simple decision analytic model was developed using the trial data to extend the analysis over a 5-year period.RESULTS:
There was no significant difference in the mean number of QALYs gained between SM and CBC (1.241 vs 1.221), but mean cost was lower for SM (£578 vs £728). The incremental net benefit estimated at a willingness to pay of £20 000 per QALY gained was £564, with an 80.8% probability of cost-effectiveness. The modeling results were consistent with the trialanalysis:
the incremental net benefit was estimated as £4221, and the probability of SM being cost-effective at 5 years was 69.7%.CONCLUSIONS:
Results suggest that pessary SM is likely to be cost-effective. The decision analytic model suggests that this result is likely to persist over longer durations.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Pessários
/
Análise Custo-Benefício
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Anos de Vida Ajustados por Qualidade de Vida
/
Prolapso de Órgão Pélvico
Limite:
Aged
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Female
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Humans
/
Middle aged
Idioma:
En
Revista:
Value Health
Ano de publicação:
2024
Tipo de documento:
Article