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 gained^1
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	−69,750^2

Total Cost (strategy_a) − Total Cost (strategy_b)]/[QALYs gained (strategy_a) − QALYs gained (strategy_b)] where Total Cost (strategy_a) > Total Cost (strategy_b] and strategy_a 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.