A cost-effectiveness analysis of Navina Smart on adult patients affected by neurogenic bowel dysfunction
DOI:
https://doi.org/10.33393/grhta.2024.3168Keywords:
Cost-effectiveness analysis, Neurogenic bowel dysfunction, Transanal irrigationAbstract
Background and Objectives: The objective of this study is to evaluate the economic impact of the device Navina Smart on patients affected by neurogenic bowel dysfunction and dependent on transanal irrigation within the Italian context. This study employs the perspective of the Italian National Health Service.
Methods: The analysis was conducted through a Markov model, comparing two scenarios: standard bowel care vs. transanal irrigation. The model operates on a 30-year time period. The results were reported in terms of net monetary benefit.
Results: Transanal irrigation therapy was dominant in all scenarios with lower costs and higher effectiveness. The population was assumed to be composed of 1,000 subjects. Setting the willingness to pay at €35,000.00/QALYs (quality-adjusted life years), the analysis yielded a net monetary benefit of €81,087 and cost savings of €66,101 per patient over 30 years.
Conclusion: The results of this study substantiate that transanal irrigation therapy treatment employing the Navina Smart device can significantly benefit patients suffering from neurogenic bowel dysfunction by relieving their symptoms. In addition, this therapy offers important cost savings for the Italian National Health Service by reducing resource utilization.
Downloads
References
Bennett J, Das JM, Emmady PD. Spinal cord injuries. StatPearls Treasure Island, Florida: StatPearls Publishing; 2022. PMID: 32809556
Altems, Valutazione HTA del dispositivo medico Peristeen Plus®. https://altems.unicatt.it/altems-research-consultancy-valutazione-hta-del-dispositivo-medico-peristeen-plus. Accessed June 2024.
Emmanuel A, Kumar G, Christensen P, et al. Long-term cost-effectiveness of transanal irrigation in patients with neurogenic bowel dysfunction. PLoS One. 2016;11(8):e0159394. https://doi.org/10.1371/journal.pone.0159394 PMID:27557052
Emmanuel A, Kurze I, Krogh K, et al. An open prospective study on the efficacy of Navina Smart, an electronic system for transanal irrigation, in neurogenic bowel dysfunction. PLoS One. 2021;16(1):e0245453. https://doi.org/10.1371/journal.pone.0245453 PMID:33513187
Dale M, Morgan H, Carter K, White J, Carolan-Rees G. Peristeen transanal irrigation system to manage bowel dysfunction: a NICE medical technology guidance. Appl Health Econ Health Policy. 2019;17(1):25-34. https://doi.org/10.1007/s40258-018-0447-x PMID:30426450
Knowles CH, Booth L, Brown SR, et al. Non-drug therapies for the management of chronic constipation in adults: the CapaCiTY research programme including three RCTs. Programme Grants for Applied Research. 2021;9(14):1-134. https://doi.org/10.3310/pgfar09140 PMID:34855315
Musco S, Bazzocchi G, Martellucci J, et al. Treatments in neurogenic bowel dysfunctions: evidence reviews and clinical recommendations in adults. Eur J Phys Rehabil Med. 2020;56(6):741-755. PMID:32935955
Sengoku A, Noto S, Nomi M, Emmanuel A, Murata T, Mimura T. Cost-effectiveness analysis of transanal irrigation for managing neurogenic bowel dysfunction in Japan. J Health Econ Outcomes Res. 2018;6(1):37-52. https://doi.org/10.36469/9781 PMID:32685570
Sakakibara R. Gastrointestinal dysfunction in movement disorders. Neurol Sci. 2021;42(4):1355-1365. https://doi.org/10.1007/s10072-021-05041-4 PMID:33538914
Hultling C. Neurogenic bowel management using transanal irrigation by persons with spinal cord injury. Phys Med Rehabil Clin N Am. 2020;31(3):305-318. https://doi.org/10.1016/j.pmr.2020.04.003 PMID:32624096
Emmanuel AV, Krogh K, Bazzocchi G, et al; Members of working group on Trans Anal Irrigation from UK, Denmark, Italy, Germany, France and Netherlands. Consensus review of best practice of transanal irrigation in adults. Spinal Cord. 2013;51(10):732-738. https://doi.org/10.1038/sc.2013.86 PMID:23958927
National Institute for Health and Care Excellence (NICE). NICE Guidance. Peristeen transanal irrigation system for managing bowel dysfunction. Feb. 23, 2018. https://www.nice.org.uk/guidance/mtg36. (Accessed June 2024).
Juul T, Christensen P. Prospective evaluation of transanal irrigation for fecal incontinence and constipation. Tech Coloproctol. 2017;21(5):363-371. https://doi.org/10.1007/s10151-017-1635-7 PMID:28550422
Wellspect Italia. Navina Medical Internal Documents. Wellspect Italia; 2024.
Christensen P, Andreasen J, Ehlers L. Cost-effectiveness of transanal irrigation versus conservative bowel management for spinal cord injury patients. Spinal Cord. 2009;47(2):138-143. https://doi.org/10.1038/sc.2008.98 PMID:18679401
Emmanuel A, Collins B, Henderson M, Lewis L, Stackhouse K. Development of a decision guide for transanal irrigation in bowel disorders. Gastrointest Nurs. 2019;17(7):24-30. https://doi.org/10.12968/gasn.2019.17.7.24
Bardsley A. Transanal irrigation systems for managing bowel dysfunction: a review. Gastrointest Nurs. 2020;18(5):18-28. https://doi.org/10.12968/gasn.2020.18.5.18
Crawshaw A, Marshall J, Bartolo DC, et al. Evaluating gravity versus pump irrigation for bowel dysfunction. Gastrointest Nurs. 2009;7(7):34-42. https://doi.org/10.12968/gasn.2009.7.7.44267
Association of the British Pharmaceutical Industry (ABPI). Our industry: facts, figures and industry data. https://www.abpi.org.uk/facts-figures-and-industry-data/. (Accessed June 2024).
Ministero della Salute. Gazzetta Ufficiale. Prestazioni Di Assistenza Specialistica Ambulatoriale – Allegato 3. Jan. 28, 2013. https://www.gazzettaufficiale.it/atto/serie_generale/caricaArticolo?art.progressivo=0&art.idArticolo=1&art.versione=1&art.codiceRedazionale=13A00528&art.dataPubblicazioneGazzetta=2013-01-28&art.idGruppo=0&art.idSottoArticolo1=10&art.idSottoArticolo=1&art.flagTipoArticolo=3 (Accessed June 2024)
Ministero della Salute. Gazzetta Ufficiale. Tariffe Delle Prestazioni Di Assistenza Ospedaliera Per Acuti, Per Tipo Di Ricovero – Allegato 1. Jan. 28, 2013. https://www.gazzettaufficiale.it/atto/serie_generale/caricaArticolo?art.progressivo=0&art.idArticolo=1&art.versione=1&art.codiceRedazionale=13A00528&art.dataPubblicazioneGazzetta=2013-01-28&art.idGruppo=0&art.idSottoArticolo1=10&art.idSottoArticolo=1&art.flagTipoArticolo=1. (Accessed June 2024)
UK Drug Database. UK Drug Information. https://www.drugs.com/uk/. (Accessed June 2024).
Analytic Health. Data-driven actionable insights. https://analytichealth.co.uk/pharmly-analytics/?gad_source=1&gclid=CjwKCAjwoJa2BhBPEiwA0l0ImNRj_Zmn4lLZR2Wf11K0lJqivzDeS_Zi0nAcbk6vo1xUnI2bIvvHlRoCiUoQAvD_BwE. (Accessed June 2024).
National Health System Business Service Authority (NHS BSA). NHS Prescription Services, Drug Tariff. https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/drug-tariff. (Accessed June 2024).
Fattore G. A proposal for guidelines for the economic evaluation of health interventions in Italy. PharmacoEcon Ital Res Artic. 2009;11(2):83-93. https://doi.org/10.1007/BF03320660
Ruggeri M, Signorini A, Caravaggio S, et al. Estimation model for healthcare costs and intensive care units access for Covid-19 patients and evaluation of the effects of remdesivir in the Portuguese context: hypothetical study. Clin Drug Investig. 2022;42(4):345-354. https://doi.org/10.1007/s40261-022-01128-8 PMID:35298832
Ruggeri M, Signorini A, Caravaggio S, et al. Modeling the potential impact of remdesivir treatment for hospitalized patients with COVID-19 in Saudi Arabia on healthcare resource use and direct hospital costs: a hypothetical study. Clin Drug Investig. 2022;42(8):669-678. https://doi.org/10.1007/s40261-022-01177-z PMID:35838880
Ruggeri M, Signorini A, Drago C, Rosiello F, Marchetti M. Model for estimating the healthcare costs and capacity of intensive care units in Italy in the treatment of patients with COVID-19: remdesivir impact assessment. AboutOpen. 2020;7(1):95-102. https://doi.org/10.33393/abtpn.2020.2213
Rechel B. Funding for public health in Europe in decline? Health Policy. 2019;123(1):21-26. https://doi.org/10.1016/j.healthpol.2018.11.014 PMID:30509874
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2024 The authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2024-10-25
Published 2024-11-18