Cost-effectiveness of an Internet-based treatment program for stress urinary incontinence

Neurourol Urodyn. 2015 Mar;34(3):244-50. doi: 10.1002/nau.22540. Epub 2013 Dec 17.


Aims: To perform a deterministic cost-utility analysis, from a 1-year societal perspective, of two treatment programs for stress urinary incontinence (SUI) without face-to-face contact: one Internet-based and one sent by post. The treatments were compared with each other and with no treatment.

Methods: We performed this economic evaluation alongside a randomized controlled trial. The study included 250 women aged 18-70, with SUI ≥ 1 time/week, who were randomized to 3 months of pelvic floor muscle training via either an Internet-based program including e-mail support from an urotherapist (n = 124) or a program sent by post (n = 126). Recruitment was web-based, and participants were self-assessed with validated questionnaires and 2-day bladder diaries, supplemented by a telephone interview with a urotherapist. Treatment costs were continuously registered. Data on participants' time for training, incontinence aids, and laundry were collected at baseline, 4 months, and 1 year. We also measured quality of life with the condition-specific questionnaire ICIQ-LUTSqol, and calculated the quality-adjusted life-years (QALYs) gained. Baseline data remained unchanged for the no treatment option. Sensitivity analysis was performed.

Results: Compared to the postal program, the extra cost per QALY for the Internet-based program ranged from 200€ to 7,253€, indicating greater QALY-gains at similar or slightly higher costs. Compared to no treatment, the extra cost per QALY for the Internet-based program ranged from 10,022€ to 38,921€, indicating greater QALY-gains at higher, but probably acceptable costs.

Conclusion: An Internet-based treatment for SUI is a new, cost-effective treatment alternative.

Keywords: Internet; cost-effectiveness; pelvic floor muscle training; self-management; stress urinary incontinence.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cost-Benefit Analysis
  • Female
  • Health Care Costs
  • Humans
  • Internet*
  • Middle Aged
  • Quality-Adjusted Life Years
  • Surveys and Questionnaires
  • Urinary Incontinence, Stress / economics*
  • Urinary Incontinence, Stress / therapy*
  • Young Adult