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Published in: Clinical Drug Investigation 10/2013

01-10-2013 | Original Research Article

Treatment Costs of Bladder Pain Syndrome/Interstitial Cystitis in Austria: A Pharmacoeconomic Approach Following Current Guidelines

Authors: Claus Riedl, Paul Engelhardt, Bernhard Schwarz

Published in: Clinical Drug Investigation | Issue 10/2013

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Abstract

Background

Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease with a significant impact on quality of life. A broad range of therapies are used to treat this condition, and patients are often excluded from receiving more expensive and more effective therapies because of cost issues.

Objective

The objective of this study was to assess the mid- and long-term costs (over 1, 5 and 10 years) of various therapies for BPS/IC.

Methods

Costs in an open-access health system (Austria) for three BPS/IC-specific therapies (intravesical hyaluronan, pentosanpolysulfate and amitriptyline), taken from the American Urological Association guidelines, were evaluated and compared with those of non-specific symptomatic therapies. Response rates for the different therapies were taken from peer-reviewed publications and used to define the need for therapy maintenance with regard to symptom improvement.

Results

Despite the highest initial costs, the reduced need for further therapy in patients with long-term symptom remission after hyaluronan therapy resulted in the lowest total treatment costs at all three timepoints. Hyaluronan was cost saving against all alternatives in standard assumptions and in all sensitivity analyses. As a limitation, treatment costs in this study are specific for Austria. However, the template used for calculation of treatment costs can be transferred to all countries by inserting local prices.

Conclusion

Disease-specific therapies with high remission rates result in significantly lower long-term costs in BPS/IC. Non-specific symptomatic therapies are most expensive. Long-term cost effectiveness is crucial in the treatment of chronic diseases to limit expenses in individual healthcare systems.
Literature
1.
go back to reference Hanno P, Dmochowski R. Status of international consensus on interstitial cystitis/bladder pain syndrome: 2008 snapshot. Neurourol Urodyn. 2009;28:274–86.PubMedCrossRef Hanno P, Dmochowski R. Status of international consensus on interstitial cystitis/bladder pain syndrome: 2008 snapshot. Neurourol Urodyn. 2009;28:274–86.PubMedCrossRef
2.
go back to reference Interstitial cystitis and painful bladder syndrome. In: Litwin MS, Saigal CS, editors. Urologic diseases in America. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office; 2012, NIH Publication No. 12-7865. Interstitial cystitis and painful bladder syndrome. In: Litwin MS, Saigal CS, editors. Urologic diseases in America. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office; 2012, NIH Publication No. 12-7865.
3.
go back to reference Temml C, Wehrberger C, Riedl CR, et al. Prevalence and correlates for interstitial cystitis symptoms in women participating in a health screening project. Eur Urol. 2006;51:803–8.PubMedCrossRef Temml C, Wehrberger C, Riedl CR, et al. Prevalence and correlates for interstitial cystitis symptoms in women participating in a health screening project. Eur Urol. 2006;51:803–8.PubMedCrossRef
4.
go back to reference Hanno PM, Burks DA, Clemens JQ, et al. AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol. 2011;185:2162–70.PubMedCrossRef Hanno PM, Burks DA, Clemens JQ, et al. AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol. 2011;185:2162–70.PubMedCrossRef
5.
go back to reference Engelhardt PF, Morakis N, Daha LK, et al. Long-term results of intravesical hyaluronan therapy in bladder pain syndrome/interstitial cystitis (BPS/IC). Int Urogynecol J. 2011;22:401–5.PubMedCrossRef Engelhardt PF, Morakis N, Daha LK, et al. Long-term results of intravesical hyaluronan therapy in bladder pain syndrome/interstitial cystitis (BPS/IC). Int Urogynecol J. 2011;22:401–5.PubMedCrossRef
6.
go back to reference Hwang P, Auclair B, Beechinor D, et al. Efficacy of pentosan polysulfate in the treatment of interstitial cystitis: a meta-analysis. Urology. 1997;50:39–43.PubMedCrossRef Hwang P, Auclair B, Beechinor D, et al. Efficacy of pentosan polysulfate in the treatment of interstitial cystitis: a meta-analysis. Urology. 1997;50:39–43.PubMedCrossRef
7.
go back to reference van Ophoven A, Hertle L. Long-term results of amitriptyline treatment for interstitial cystitis. J Urol. 2005;174:1837–40.PubMedCrossRef van Ophoven A, Hertle L. Long-term results of amitriptyline treatment for interstitial cystitis. J Urol. 2005;174:1837–40.PubMedCrossRef
8.
go back to reference Riedl CR, Engelhardt PF, Daha LK, et al. Hyaluronan treatment of interstitial cystitis/painful bladder syndrome. Int Urogynecol J. 2008;19:717–21.CrossRef Riedl CR, Engelhardt PF, Daha LK, et al. Hyaluronan treatment of interstitial cystitis/painful bladder syndrome. Int Urogynecol J. 2008;19:717–21.CrossRef
9.
go back to reference Hanno PM. Analysis of long-term elmiron therapy for interstitial cystitis. Urology. 1997;49 (Suppl 5A):93–9. Hanno PM. Analysis of long-term elmiron therapy for interstitial cystitis. Urology. 1997;49 (Suppl 5A):93–9.
10.
go back to reference Payne CK, Joyce GF, Wise M, et al. Interstitial cystitis and painful bladder syndrome. J Urol. 2007;177:2042–9.PubMedCrossRef Payne CK, Joyce GF, Wise M, et al. Interstitial cystitis and painful bladder syndrome. J Urol. 2007;177:2042–9.PubMedCrossRef
11.
go back to reference Richter Toft B, Nordling J. Recent developments of intravesical therapy of painful bladder syndrome/interstitial cystitis: a review. Curr Opin Urol. 2006;16:268–72. Richter Toft B, Nordling J. Recent developments of intravesical therapy of painful bladder syndrome/interstitial cystitis: a review. Curr Opin Urol. 2006;16:268–72.
12.
go back to reference Kallestrup EB, Jorgensen SS, Nordling J, et al. Treatment of interstitial cystitis with Cystistat: a hyaluronic acid product. Scand J Urol Nephrol. 2005;39:143–7.PubMedCrossRef Kallestrup EB, Jorgensen SS, Nordling J, et al. Treatment of interstitial cystitis with Cystistat: a hyaluronic acid product. Scand J Urol Nephrol. 2005;39:143–7.PubMedCrossRef
13.
go back to reference Anger JT, Zabihi N, Clemens JQ, et al. Treatment choice, duration, and cost in patients with interstitial cystitis and painful bladder syndrome. Int Urogynecol J. 2011;22:395–400.PubMedCrossRef Anger JT, Zabihi N, Clemens JQ, et al. Treatment choice, duration, and cost in patients with interstitial cystitis and painful bladder syndrome. Int Urogynecol J. 2011;22:395–400.PubMedCrossRef
14.
go back to reference Wu EQ, Birnbaum H, Mareva M, et al. Interstitial cystitis: cost, treatment and co-morbidities in an employed population. Pharmacoeconomics. 2006;24:55–65.PubMedCrossRef Wu EQ, Birnbaum H, Mareva M, et al. Interstitial cystitis: cost, treatment and co-morbidities in an employed population. Pharmacoeconomics. 2006;24:55–65.PubMedCrossRef
15.
go back to reference Clemens JQ, Markossian T, Calhoun EA. Comparison of economic impact of chronic prostatitis/chronic pelvic pain syndrome and interstitial cystitis/painful bladder syndrome. Urology. 2009;73:743–6.PubMedCrossRef Clemens JQ, Markossian T, Calhoun EA. Comparison of economic impact of chronic prostatitis/chronic pelvic pain syndrome and interstitial cystitis/painful bladder syndrome. Urology. 2009;73:743–6.PubMedCrossRef
16.
go back to reference Clemens JQ, Meenan RT, Rosetti MC, et al. Costs of interstitial cystitis in a managed care population. Urology. 2008;71:776–80.PubMedCrossRef Clemens JQ, Meenan RT, Rosetti MC, et al. Costs of interstitial cystitis in a managed care population. Urology. 2008;71:776–80.PubMedCrossRef
Metadata
Title
Treatment Costs of Bladder Pain Syndrome/Interstitial Cystitis in Austria: A Pharmacoeconomic Approach Following Current Guidelines
Authors
Claus Riedl
Paul Engelhardt
Bernhard Schwarz
Publication date
01-10-2013
Publisher
Springer International Publishing
Published in
Clinical Drug Investigation / Issue 10/2013
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI
https://doi.org/10.1007/s40261-013-0119-4

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