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Sánchez Iriso, Eduardo

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Sánchez Iriso

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Eduardo

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Economía

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0000-0002-5320-8732

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2609

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2013 - 201912020 - 20231
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Subject: Cost-effectiveness ×

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    PublicationOpen Access
    Cost-utility analysis of prostatic artery embolization for treatment of lower urinary tract symptoms
    (2023) Capdevila, Ferran; Insausti, Íñigo; San Miguel Elcano, Ramón; Sánchez Iriso, Eduardo; Montesino San Martín, Manuel; Ciencias de la Salud; Osasun Zientziak; Economía; Ekonomia
    Purpose: To perform a post hoc cost–utility analysis of a randomized controlled clinical trial comparing prostatic artery embolization (PAE) and transurethral resection of the prostate (TURP) in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia. Materials and Methods: We conducted a cost–utility analysis over a 5-year period to compare PAE versus TURP from a Spanish National Health System perspective. Data were collected from a randomized clinical trial performed at a single institution. Effectiveness was measured as quality-adjusted life years (QALYs), and an incremental cost-effectiveness ratio (ICER) was derived from the cost and QALY values associated with these treatments. Further sensitivity analysis was performed to account for the impact of reintervention on the cost-effectiveness of both procedures. Results: At the 1-year follow-up, PAE resulted in mean cost per patient of €2904.68 and outcome of 0.975 QALYs per treatment. In comparison, TURP had cost €3846.72 per patient and its outcome was 0.953 QALYs per treatment. At 5 years, the cost for PAE and TURP were €4117.13 and €4297.58, and the mean QALY outcome was 4.572 and 4.487, respectively. Analysis revealed an ICER of €2121.15 saved per QALY gained when comparing PAE to TURP at long-term follow-up. Reintervention rate for PAE and TURP was 12% and 0%, respectively. Conclusions: Compared to TURP, in short term, PAE could be considered a cost-effective strategy within the Spanish healthcare system for patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia. However, in long term, the superiority is less apparent due to higher reintervention rates.
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    PublicationOpen Access
    Cost effectiveness analysis of the surgical treatment of female urinary incontinence using slings
    (2013) Montesino Semper, Manuel F.; Jiménez Calvo, Jesús M.; Cabasés Hita, Juan Manuel; Sánchez Iriso, Eduardo; Hualde Alfaro, Antonio; García García, Diego; Economía; Ekonomia
    Objective. To determine the cost-utility and cost-effectiveness of the surgical treatment of female urinary incontinence using suburethral slings compared with therapeutic abstention. Study Design. An economic analysis was performed on 69 women receiving surgical treatment for urinary incontinence using suburethral slings. To calculate the procedure´s cost-effectiveness, an incremental analysis up to 1 year was performed using the incremental cost-effectiveness ratio (ICER). The costs were calculated using a cost-by-process model. Answers to the health-related quality of life questionnaires EQ-5D (generic) and International Consultation Incontinence Questionnaire Short-form (specific) were collected before the operation and as well as 1 month and 1 year post-operation to calculate the utility, using quality-adjusted life years (QALY), and the effectiveness, respectively. A sensitivity analysis was performed by calculating the Incremental Cost-Effectiveness Ratio (ICER) at 5 years post-operation. To complete the economic evaluation, we derived confidence ellipses and acceptability curves. The analysis was conducted for the entire sample and also for each type of urinary incontinence. Results. In total, 45 women presented with stress incontinence, 15 with mixed incontinence and 9 with incontinence associated with prolapse. The average cost per patient at 1 year post-operation was 1,220 €. The QALY achieved at 1 year was 0.046. The results reveal an ICER at 1 year of 26,288 €/QALY, which is below the cost-effectiveness threshold considered acceptable, and this value was lower for stress incontinence (21,191 €/QALY). To achieve greater temporal perspective, we examined the ICER at 5 years, which was 10,141 €/QALY, demonstrating that the programme is clearly efficient. The cost-effectiveness was 106.5 €/ International Consultation Incontinence Questionnaire Short-form unit. Conclusion. Surgery for female urinary incontinence using slings is cost-effective compared with abstention in our public health environment.