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

Stefanie M. Croghan, Robert Malcolm, Hugh D. Flood, Stuart Mealing, Brooke Avey, Gavin Leonard, James Wright, Niall F. Davis, Michael T. Walsh

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)154-164
Number of pages11
JournalJournal of Medical Economics
Volume27
Issue number1
DOIs
Publication statusPublished - 2024

Keywords

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

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