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Cost-effectiveness analysis of sacral nerve stimulation as treatment for severe irritable bowel syndrome
L S Tipsmark1, J Fassov2,3, L Lundby3
1Danish Center for Health Care Improvement, Aalborg University, Aalborg, Denmark.
Aim:
Early results from sacral nerve stimulation (SNS) for severe irritable bowel syndrome (IBS) are promising but estimates of cost-effectiveness are lacking. Our object was to perform a cost-effectiveness analysis for SNS as an alternative to no treatment of IBS.
Method:
This retrospective analysis was based on the results from a randomized controlled crossover study with a cost-utility analysis performed on patient-level data and modelling of censored data over a projected period of time of up to 20 years. The analysis was conducted on an intention-to-treat approach. For estimation of the uncertainty of the incremental cost-effectiveness ratio a bias corrected bootstrap analysis was performed.
Results:
Cost-effectiveness was not reached for 4 years after permanent implantation (£31 270 per quality-adjusted life years), which was the upper limit for patient follow-up, but our data imply a cost-effectiveness from a 7-year perspective onwards.
Conclusion:
The study indicates the SNS treatment for IBS is cost effective from a 7-year perspective onwards.
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