Cost-Effectiveness Analysis of Long-Term Intermittent Self-Catheterization with Hydrophilic-Coated and Uncoated Catheters in Patients with Spinal Cord Injury in Japan

To evaluate the cost effectiveness of disposable, hydrophilic-coated catheters in Japan.

A Markov decision model previously applied in a European study was used to evaluate the cost effectiveness of intermittent self-catheterization (ISC) with hydrophilic-coated catheters in Japanese spinal cord injury (SCI) patients suffering from chronic urinary retention from a lifetime perspective. To adjust the model to a Japanese setting, relevant Japanese data regarding the baseline risk of urinary tract infection (UTI), the average age at onset of SCI, costs, and general mortality were extracted from published literature, national statistics, or the opinions of Japanese experts. The direct medical costs, quality-adjusted life years (QALYs) and life years gained (LYG) were calculated from the payers' perspective. An annual discount rate of 2% was applied to both the costs and the effects.

The incremental cost of hydrophilic-coated catheters was 1 279 886 yen (US$ 10 578 at an exchange rate of US$ 1 = 121 yen) per SCI patient, but they yielded an additional 0.334 QALYs and 0.781 LYG compared with uncoated catheters. The incremental cost-effectiveness ratio (ICER) of hydrophilic-coated catheters vs. uncoated catheters was 3 826 351 yen/QALY (US$ 31 623/QALY) gained and 1 639 562 yen/LYG (US$ 13 550/LYG).

The ICER of 3.8 million yen (US$ 31 405) falls well within the Japanese societal willingness to pay per QALY gained; therefore, hydrophilic-coated catheters can be considered highly cost-effective in Japan compared with uncoated catheters. However, because of the lack of relevant studies, a number of key parameters could not be based on Japanese data, and further research among people with SCI in Japan is recommended.

Lower urinary tract symptoms. 2015 Nov 30 [Epub]

Toyohiko Watanabe, Shingo Yamamoto, Momokazu Gotoh, Tadanori Saitoh, Osamu Yokoyama, Tatsunori Murata, Masayuki Takeda

Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan., Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan., Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan., Nihon University School of Medicine, Itabashi, Japan., Department of Urology, University of Fukui Faculty of Medical Sciences, Fukui, Japan., CRECON Medical Assessment Inc., Tokyo, Japan., Department of Urology, University of Yamanashi, Kofu, Japan.

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