对女性过度活动膀的侵入性泌尿动力学研究的长期成本效益
Helen Bell-Gorrod1, Praveen Thokala1, Suzanne Breeman2
1School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
BJU international
|April 19, 2025
概括
对于女性耐火过活膀 (OAB) 的尿动力学研究 (UDS) 不太可能具有成本效益. 分析表明,UDS更昂贵,质量调整后生命年 (QALY) 收益最小,这表明从英国的寿命角度来看,价值有限.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 卫生经济学 卫生经济学
背景情况:
- 耐火性过活性膀 (OAB) 显著影响生活质量.
- 尿动力学研究 (UDS) 是OAB管理中使用的侵入性诊断工具.
- 在OAB中UDS的成本效益需要进行彻底的评估.
研究的目的:
- 评估使用侵入性泌尿动力学研究 (UDS) 的终身成本效益,而不是单独对患有难治性过活膀 (OAB) 的女性进行综合性临床评估 (CCA).
- 利用FUTURE随机对照试验的数据来为经济模型提供信息.
主要方法:
- 开发一个模拟FUTURE试验24个月结果的经济模型.
- 使用长期结果数据,对终身成本和经质量调整的寿命年 (QALYs) 的推断.
- 进行了敏感性分析,以测试发现的稳定性.
主要成果:
- 在终身期内,UDS加CCA的成本比CCA高1380英,QALY比CCA单独低0.002英,成本效益率为20,000英/QALY的概率为23.4%.
- 在混合性尿失禁的小组中,UDS显示改善了QALY,但成本更高 (ICER£26,462/QALY).
- 除了使用FUTURE试验中的完整病例分析参数外,结果很强大.
结论:
- 尿动力学研究 (UDS) 不太可能从英国终身的角度来看,在治疗妇女的耐火性过活性膀 (OAB) 方面具有成本效益.
- 目前证据的局限性需要进一步的长期后续研究,以减少经济建模中的不确定性.
- 这些发现表明,替代的管理策略或精细的UDS患者选择可能是合理的.
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