Cost-effectiveness Analysis: Autologous Rectus Fascial Sling Versus Retropubic Midurethral Sling for Female Stress...

Area of Science:

• Urology
• Health Economics
• Surgical Outcomes

Background:

• Limited economic data exist for comparing retropubic midurethral sling (MUS) and autologous fascial sling (AFS) for stress urinary incontinence.
• Understanding the cost-effectiveness of these procedures is crucial for healthcare providers and policymakers.

Purpose of the Study:

• To evaluate the cost-effectiveness of autologous rectus fascial sling (ARFS) compared to retropubic midurethral sling (RMUS).
• Analysis conducted from both hospital and broader healthcare perspectives.

Main Methods:

• A decision tree model with a 1-year follow-up was utilized.
• Key variables included objective success rates, complication management, and retreatment costs.
• Outcomes were measured in incremental cost-effectiveness ratio (ICER) and cost per quality-adjusted life-year (QALY).

Main Results:

• From a hospital perspective, RMUS was more costly but more effective (ICER: $17,452/QALY).
• From a healthcare perspective, RMUS was the dominant strategy (ICER: -$1,943.32/QALY).
• ARFS could become cost-effective if its success rate reached ≥84.39% or RMUS surgery cost exceeded $2,654.36.

Conclusions:

• Retropubic midurethral sling (RMUS) is the cost-effective and dominant treatment from hospital and healthcare perspectives, respectively.
• Cost-effectiveness is sensitive to variations in surgical costs and success rates for both procedures.