Treating Urge Incontinence in Older Women: A Cost-Effective Investment in Quality-Adjusted Life-Years (QALY)
Table 2
Yearly and incremental costs (US$), episodes avoided, and quality-adjusted life years (QALYs) gained for each strategy with crossover and strategies compared to each other.
Strategies with crossover
Cost (s.d.)
Number of incontinence episodes avoided (s.d.)
QALY gain (s.d.)
Average cost per episode avoided
Average cost per QALY gained
Baseline values for each strategy
Limited behavioral
323 (22.9)
308.7 (115.6)
0.051 (0.007)
1.05
6333
Full behavioral
340 (105.1)
362 (140.2)
0.092 (0.006)
0.94
3696
Drug therapy
898 (277.2)
354 (123.8)
0.084 (0.002)
2.54
10609
Incremental costs (s.d.)
Incremental number of incontinence episodes avoided (s.d.)
Incremental QALY gain (s.d.)
Incremental cost per episode avoided
Incremental cost per QALY gained1
Each strategy compared to a less costly strategy
Full behavioral therapy to limited behavioral therapy
17 (25.2)
53.3 (71.8)
0.041 (009)
0.32
415
Drug therapy to limited behavioral therapy
575 (23.1)
45.3 (87.6)
0.032 (.007)
12.69
17,424
Drug therapy to full behavioral therapy
558 (11.8)
−8.00 (94.68)
−.008 (006)
−69.75
−69,7502
Total Cost (strategya) − Total Cost (strategyb)]/[QALYs gained (strategya) − QALYs gained (strategyb)] where Total Cost (strategya) > Total Cost (strategyb] and strategya is first listed in the row. Drug has higher costs and lower outcomes than full behavioral therapy, so incremental values are negative, for example: row 6, column 5: (898 − 340)/(354 − 362) = −69.75 or paying more for a reduced outcome.