Is Burch colposuspension ever cost-effective compared with tension-free vaginal tape for stress incontinence?

Published

Journal Article

OBJECTIVE: This study was undertaken to evaluate the cost-effectiveness of Burch colposuspension compared with tension-free vaginal tape. STUDY DESIGN: A Markov decision model was developed to compare costs (2005 US dollars) and effectiveness (quality-adjusted life years) of Burch and tension-free vaginal tape for stress urinary incontinence over 10 years from a health care system perspective. After surgery, outcomes included cure, persistent stress urinary incontinence followed by second surgery, and persistent stress urinary incontinence and mesh erosion after tension-free vaginal tape. An incremental cost-effectiveness ratio of less than $50,000 per quality-adjusted life year was considered cost-effective. RESULTS: For the base-case, the Burch strategy cost more than tension-free vaginal tape ($9320 vs $8081), but was slightly more effective (7.260 vs 7.248 quality-adjusted life years). The incremental cost-effectiveness ratio was $98,755 per quality-adjusted life year. The incremental cost-effectiveness ratio was less than $50,000 per quality-adjusted life year when the relative risk of cure after Burch to tension-free vaginal tape was greater than 1.09. CONCLUSION: Burch colposuspension was not cost-effective compared with tension-free vaginal tape. However, if the tension-free vaginal tape failure rate was to increase over time, Burch may become cost-effective.

Full Text

Duke Authors

Cited Authors

  • Wu, JM; Visco, AG; Weidner, AC; Myers, ER

Published Date

  • July 2007

Published In

Volume / Issue

  • 197 / 1

Start / End Page

  • 62.e1 - 62.e5

PubMed ID

  • 17618760

Pubmed Central ID

  • 17618760

Electronic International Standard Serial Number (EISSN)

  • 1097-6868

Digital Object Identifier (DOI)

  • 10.1016/j.ajog.2007.02.039

Language

  • eng

Conference Location

  • United States