Cost-effectiveness of duloxetine: the Stress Urinary Incontinence Treatment (SUIT) study.

Journal article

OBJECTIVE: To assess the cost-effectiveness of duloxetine compared with conservative therapy in women with stress urinary incontinence (SUI). METHODS: Cost and outcome data were taken from the Stress Urinary Incontinence Treatment (SUIT) study, a 12-month, prospective, observational, naturalistic, multicenter, multicountry study. Costs were assessed in UK pound and outcomes in quality adjusted life years using responses to the EuroQol (EQ-5D); numbers of urine leaks were also estimated. Potential selection bias was countered using multivariate regression and propensity score analysis. RESULTS: Duloxetine alone, duloxetine in combination with conservative treatment, and conservative treatment alone were associated with roughly two fewer leaks per week compared with no treatment. Duloxetine alone and with conservative treatment for SUI were associated with incremental quality-adjusted life-years (QALYs) of about 0.03 over a year compared with no treatment or with conservative treatment alone. Conservative treatment alone did not show an effect on QALYs. None of the interventions appeared to have marked impacts on costs over a year. Depending on the form of matching, duloxetine either dominated or had an incremental cost-effectiveness ratio (ICER) below pound900 per QALY gained compared with no treatment and with conservative treatment alone. Duloxetine plus conservative therapy had an ICER below pound5500 compared with no treatment or conservative treatment alone. Duloxetine compared with duloxetine plus conservative therapy showed similar outcomes but an additional cost for the combined intervention. CONCLUSIONS: Although the limitations of the use of SUIT's observational data for this purpose need to be acknowledged, the study suggests that initiating duloxetine therapy in SUI is a cost-effective treatment alternative.

Authors: Mihaylova, B; Pitman, R; Tincello, D; van der Vaart, H; Tunn, R

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
• Volume: 13
• Issue: 5
• Pages: 565-572
• Publication date: 2010-08-01
• DOI: 10.1111/j.1524-4733.2010.00729.x
• EISSN: 1524-4733
• ISSN: 1098-3015
• Language: English
• Keywords: Multivariate Analysis; Middle Aged; Regression Analysis; Quality-Adjusted Life Years; Thiophenes; Humans; Great Britain; Urinary Incontinence, Stress; Outcome Assessment (Health Care); Health Resources; Health Status Indicators; Cost-Benefit Analysis; Internationality; Female; Cohort Studies; Quality of Life; Adrenergic Uptake Inhibitors; Propensity Score; Prospective Studies; Women's Health