Table 3

Healthcare resource utilization and other data included into the fesoterodine economic model

Input

Controlled (continent)

Uncontrolled (incontinent)

Untreated (incontinent)

Source


Proportion using incontinence pads

0%

67%

67%

[24]

Number of incontinence pads/day

0

4.23

4.23

[48]

Number of general practitioner visits/month

0.133*

0.2

0.2

[48]

Number of specialist visits/month

0.117*

0.15*

0.15

[48]

Number of laboratory tests/month

0.033*

0.078*

0.078

[48]

OAB-related Co morbidities: rate per year


Fracture: 6-month probability of a fall with fractures (4% decrease in utility values [49]**)

2.5%

5.3%

5.3%

[48,50]

Skin infection: 6-month probability

10.7% (0.3 infections per person in entire population) (2.8 events/affected patient)

9.3% (0.6 infections per person in entire population) (6.5 events/affected patient)

9.3%

[48]

UTI: 6-month probability

19% (0.3 infections per person in entire population) (1.6 events/affected patient)

30.7% (0.7 infections per person in entire population) (2.3 events/affected patient)

30.7%

[48]


Depression (48% decrease in utility values [51])***

% female in clinical trial data

-

80.87% OAB w/UUI****

-

[52]

Women

9.10%

18.90%

-

[52]

Men

4.30%

18.60%

-

[52]

Overall

8.08%

18.84%

-

[52]


Nursing home: Admission rate per 1000 patient-years

Women

31

73

73

[53]

Men

24

98

98

[53]


(% decrease in utility values [49])*****

Overall

29.5

78.3

78.3

[53]


Utility values [17,18]

0.9569

0.9412

0.9332 (baseline value)


*Bolge et al. 2006, showed that successfully-treated patients saw a GP 25% fewer times than unsuccessfully-treated patients. Additionally, the mean number of non-GP visits in past 6 months was 0.9 and 0.7, respectively for incontinent and continent patients. Bolge et al 2006 also showed the following number of urinary test: 0.47 and 0.2 urine tests/patient over last 6 months, respectively for incontinent and continent patients. **Reported wrist fracture utility was 0.96. Assumed 0.7 utility for 7 weeks, referenced from National Osteoporosis Foundation review. ***Women with urinary incontinence with major depression have utility of 0.45. Women with urinary incontinence without major depression have utility of 0.86. 0.45 represents a 48% reduction from 0.86. This means a patient experiencing depression would have 48% reduction in QALY gain than a comparable patient experiencing no co morbidities. ****By using the proportion of women and men in the trial data (80.87% women, 19.13% men), we calculated the weighted average of the above data for inclusion into the model. *****There are no published data to provide the difference in utility of OAB patients in and out of nursing homes. One estimate is to use the utility value of nursing home admission due to hip fracture provided in the UK HTA (0.4), but this value would be an overestimation of the utility decrement for our OAB population since patients who enter the nursing home due to a hip fracture are in much worse physical condition (and, it follows, utility) than patients entering a nursing home due to OAB and/or incontinence. For this reasons, no decrease in utility value is considered.

Arlandis-Guzman et al. BMC Urology 2011 11:9   doi:10.1186/1471-2490-11-9

Open Data