| Cost-consequence analysis evaluating the use of botulinum neurotoxin-A in patients with detrusor overactivity based on clinical outcomes observed at a single UK centre. | |
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MedLine Citation:
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PMID: 16413656 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE(S): This study aimed to assess the resource utilisation, health benefits and cost-effectiveness of intra-detrusor injections of botulinum neurotoxin-A (BoNT/A) in patients with overactive bladder (OAB). METHODS: 101 patients with urodynamically-proven detrusor overactivity of either neurogenic (NDO; n = 63) or idiopathic (IDO; n = 38) origin received intra-detrusor injections of 200-300 units of BoNT/A in 20-30 ml saline as part of a research protocol. Twenty-nine patients received repeat injections after 7-26 months. Symptom severity and urodynamic parameters were assessed at 0, 4 and 16 weeks. The cost of therapy was quantified based on the NHS resources used by typical patients and was used to calculate the cost-effectiveness of BoNT/A compared with standard care from the perspective of the UK NHS. RESULTS: In an intent-to-treat analysis, 82% of patients showed a 25% or greater improvement in at least two out of five parameters (urinary frequency, urgency, urgency incontinence episodes, maximum cystometric capacity and maximum detrusor pressure) four weeks after treatment, reducing to 65% after 16 weeks. A 50% or greater improvement in the frequency of micturition, urgency or urgency incontinence was seen in 73% of patients at four weeks and 54% at 16 weeks. There were no significant differences between IDO and NDO patients in the proportion meeting these endpoints. Therapy cost pounds 826 per patient, with a cost-effectiveness ratio of pounds 617 per patient-year with > or = 25% clinical improvement. CONCLUSION(S): This study demonstrates that intra-detrusor BoNT/A is an effective treatment for OAB that is highly likely to be cost-effective in both idiopathic and neurogenic disease. |
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Authors:
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Vinay Kalsi; Roshni B Popat; Apostolos Apostolidis; Rajesh Kavia; Isaac A O Odeyemi; Helen A Dakin; Juliet Warner; Soheir Elneil; Clare J Fowler; Prokar Dasgupta |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2005-12-22 |
Journal Detail:
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Title: European urology Volume: 49 ISSN: 0302-2838 ISO Abbreviation: Eur. Urol. Publication Date: 2006 Mar |
Date Detail:
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Created Date: 2006-02-22 Completed Date: 2006-09-07 Revised Date: 2012-03-07 |
Medline Journal Info:
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Nlm Unique ID: 7512719 Medline TA: Eur Urol Country: Switzerland |
Other Details:
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Languages: eng Pagination: 519-27 Citation Subset: IM |
Affiliation:
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The National Hospital for Neurology and Neurosurgery, London, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Botulinum Toxins, Type A / administration & dosage, economics, therapeutic use* Cost-Benefit Analysis Female Great Britain Humans Injections, Intramuscular Male Middle Aged Muscle, Smooth / drug effects Neuromuscular Agents / therapeutic use* Urinary Incontinence / drug therapy*, economics |
| Grant Support | |
ID/Acronym/Agency:
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799//Multiple Sclerosis Society |
| Chemical | |
Reg. No./Substance:
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0/Neuromuscular Agents; EC 3.4.24.69/Botulinum Toxins, Type A |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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