Cost-effectiveness analysis of sacral nerve stimulation as treatment for severe irritable bowel syndrome

Colorectal Dis. 2016 Jan;18(1):O30-6. doi: 10.1111/codi.13149.

Abstract

Aim: Early results from sacral nerve stimulation (SNS) for severe irritable bowel syndrome (IBS) are promising but estimates of cost-effectiveness are lacking. Our object was to perform a cost-effectiveness analysis for SNS as an alternative to no treatment of IBS.

Method: This retrospective analysis was based on the results from a randomized controlled crossover study with a cost-utility analysis performed on patient-level data and modelling of censored data over a projected period of time of up to 20 years. The analysis was conducted on an intention-to-treat approach. For estimation of the uncertainty of the incremental cost-effectiveness ratio a bias corrected bootstrap analysis was performed.

Results: Cost-effectiveness was not reached for 4 years after permanent implantation (£31 270 per quality-adjusted life years), which was the upper limit for patient follow-up, but our data imply a cost-effectiveness from a 7-year perspective onwards.

Conclusion: The study indicates the SNS treatment for IBS is cost effective from a 7-year perspective onwards.

Keywords: Cost-utility analysis; cost-effectiveness; irritable bowel syndrome; sacral nerve stimulation.

MeSH terms

  • Cost-Benefit Analysis*
  • Cross-Over Studies
  • Denmark
  • Electric Stimulation Therapy / economics*
  • Humans
  • Irritable Bowel Syndrome / economics
  • Irritable Bowel Syndrome / therapy*
  • Lumbosacral Plexus*
  • Quality-Adjusted Life Years
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Severity of Illness Index