OBJECTIVE: To estimate the long-term cost-effectiveness of specialised treatment options for medically refractory idiopathic @entity2182 ( @entity2182 ) wet. @entity1 AND METHODS: The cost-effectiveness of competing treatment options for @entity1 with medically refractory idiopathic @entity2182 wet was estimated from the perspective of the National Health Service in the UK. We compared sacral nerve stimulation (SNS) with @entity129 ( @entity129 ) or @entity16922 ( @entity16922 ) with optimal medical therapy (OMT), botulinum toxin type A (BoNT-A) injections, and percutaneous tibial nerve stimulation (PTNS). We used a Markov model with a 10-year time horizon for all treatment options with the exception of PTNS, which has a time horizon of 5  years. Costs and effects (measured as quality-adjusted life years) were calculated to derive incremental cost-effectiveness ratios (ICERs). Direct medical resources included are: device and drug acquisition costs, pre-procedure and procedure costs, and the cost of managing adverse events. Deterministic sensitivity analyses were performed to test robustness of results. RESULTS: At 5  years, SNS ( @entity129 or @entity16922 ) was more effective and less costly than PTNS. Compared with OMT at 10  years, SNS ( @entity129 or @entity16922 ) was more costly and more effective, and compared with BoNT-A, SNS @entity129 was less costly and more effective, and SNS @entity16922 was more costly and more effective. Decreasing the BoNT-A dose from 150 to 100  IU marginally increased the 10  year ICERs for SNS @entity16922 and @entity129 (SNS @entity129 was no longer dominant). However, both SNS options remained cost-effective. CONCLUSION: In the management of @entity1 with idiopathic @entity2182 wet, the results of this cost-utility analysis favours SNS ( @entity129 or @entity16922 ) over PTNS or OMT, and the most efficient treatment strategy is SNS @entity129 over BoNT-A over a 10-year period.

The cost-effectiveness of sacral nerve stimulation (SNS) for the treatment of idiopathic medically refractory XXXX (wet) in the UK.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity129 :: ('MESH:D003389', 'Disease') :: ['percutaneous nerve evaluation', 'PNE'] @entity2182 :: ('MESH:D053201', 'Disease') :: ['overactive bladder', 'OAB'] @entity16922 :: ('MESH:D020265', 'Disease') :: ['tined-lead evaluation', 'TLE']
@entity2182 :: (MESH:D053201,Disease) :: ['overactive bladder']
