Cost-Utility Analysis of Implantable Tibial Neuromodulation for Urinary Incontinence

A 3-year cost-utility model compares implantable tibial nerve neuromodulation to conservative therapy for urgency urinary incontinence from a US payer perspective. The analysis, authored by Cindy L. Amundsen and updated in April 2026, uses a Markov model with 20,000 Monte Carlo simulations to evaluate costs and quality-adjusted life-years. Results indicate the implantable system is both more effective and less costly, with a dominant incremental cost-effectiveness ratio of -$17,818 per QALY.

Use Cases

• Conducting a cost-effectiveness analysis for medical device adoption based on the described Markov model and Monte Carlo simulations.
• Comparing long-term healthcare costs of surgical versus non-surgical interventions based on the 3-year payer perspective.
• Modeling patient outcomes and downstream events like falls and nursing home entry based on the described health state transitions.

Strengths

• Model parameters derived from a pivotal clinical trial with N=150 participants.
• Probabilistic sensitivity analysis performed with 20,000 Monte Carlo simulations.
• Costs and outcomes are discounted at 3% annually and expressed in 2025 US dollars.

Limitations

• Column-level documentation is absent; field semantics must be inferred after download.
• The 3-year base-case horizon may miss longer-term durability effects, as noted in the description.
• Row count is unknown, which may limit suitability assessment.

Provenance

Source

figshare

Collection Method

Cohort state-transition (Markov) model with annual cycles, derived from clinical trial data.

Time Range

3-year analysis horizon.

Freshness

Last updated 2026-04-21 15:39:15; freshness should be verified.

Geography

United States (US payer perspective).