Cost-effectiveness of a novel urethral catheter safety device in preventing catheterization injuries in the UK

Abstract

Aims

Intraurethral catheter balloon inflation is a substantial contributor to significant catheter-related urethral injury. A novel safety valve has been designed to prevent these balloon-inflation injuries. The purpose of this evaluation was to assess the cost-effectiveness of urethral catheterisation with the safety valve added to a Foley catheter versus the current standard of care (Foley catheter alone).

Materials and methods

The analysis was conducted from the UK public payer perspective on a hypothetical cohort of adults requiring transurethral catheterization. A decision tree was used to capture outcomes in the first 30 days following transurethral catheterization, followed by a Markov model to estimate outcomes over a person’s remaining lifetime. Clinical outcomes included catheter balloon injuries [CBIs], associated short-term complications, urethral stricture disease, life years and QALYs. Health-economic outcomes included total costs, incremental cost-effectiveness ratio, net monetary benefit (NMB) and net health benefit.

Results

Over a person’s lifetime, the safety valve was predicted to reduce CBIs by 0.04 per person and CBI-related short-term complications by 0.03 per person, and nearly halve total costs. The safety valve was dominant, resulting in 0.02 QALYs gained and relative cost savings of £93.19 per person. Probabilistic sensitivity analysis indicated that the safety valve would be cost-saving in 97% of simulations run versus standard of care.

Conclusions

The addition of a novel safety valve aiming to prevent CBIs during transurethral catheterization to current standard of care was estimated to bring both clinical benefits and cost savings.

Keywords:

• Catheter balloon injury
• transurethral catheterization
• economic evaluation
• cost-effectiveness analysis
• urethral safety valve

JEL Classification Codes:

• I00
• I
• C02
• C

Transparency

Declaration of funding

As part of this analysis, the York Health Economics Consortium were funded by Class Medical to construct the health economic model and co-author the manuscript.

Declaration of financial/other relationships

None stated.

Author contributions

All authors were involved in the conceptualization of the model design and economic analysis. RM, SM and BA conducted the economic analysis. All authors were involved in the interpretation of the results. RM, SM and BA were responsible for the initial draft of the manuscript, with medical writing assistance. SC, HF, JW, GL, ND, and MW, provided critical revision of the manuscript at multiple stages.

Acknowledgements

Medical writing and editorial assistance with the preparation of this manuscript was provided by Karolina Badora.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.