A Cost-effectiveness Analysis of Navina Smart on Adult Patients Affected by Neurogenic Bowel Dysfunction

Overview

Journal Glob Reg Health Technol Assess

Specialty Health Services

Date 2024 Nov 22

PMID 39574806

Authors

Matteo Ruggeri

Alessandro Signorini

Silvia Caravaggio

Gabriele Righi

Affiliations

Soon will be listed here.

Abstract

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.

References

Emmanuel A, Krogh K, Bazzocchi G, Leroi A, Bremers A, Leder D . Consensus review of best practice of transanal irrigation in adults. Spinal Cord. 2013; 51(10):732-8. DOI: 10.1038/sc.2013.86. View

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. 2018; 17(1):25-34. PMC: 6345726. DOI: 10.1007/s40258-018-0447-x. View

Sakakibara R . Gastrointestinal dysfunction in movement disorders. Neurol Sci. 2021; 42(4):1355-1365. DOI: 10.1007/s10072-021-05041-4. View

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. 2020; 6(1):37-52. PMC: 7309949. DOI: 10.36469/9781. View

Juul T, Christensen P . Prospective evaluation of transanal irrigation for fecal incontinence and constipation. Tech Coloproctol. 2017; 21(5):363-371. DOI: 10.1007/s10151-017-1635-7. View

Emmanuel A, Kumar G, Christensen P, Mealing S, Storling Z, Andersen F . Long-Term Cost-Effectiveness of Transanal Irrigation in Patients with Neurogenic Bowel Dysfunction. PLoS One. 2016; 11(8):e0159394. PMC: 4996513. DOI: 10.1371/journal.pone.0159394. View

Ruggeri M, Signorini A, Caravaggio S, Alraddadi B, AlAli A, Jarrett J . 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. PMC: 9284952. DOI: 10.1007/s40261-022-01177-z. View

Ruggeri M, Signorini A, Caravaggio S, Rua J, Luis N, Braz S . 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. PMC: 8928238. DOI: 10.1007/s40261-022-01128-8. View

Rechel B . Funding for public health in Europe in decline?. Health Policy. 2018; 123(1):21-26. DOI: 10.1016/j.healthpol.2018.11.014. View

10.

Christensen P, Andreasen J, Ehlers L . Cost-effectiveness of transanal irrigation versus conservative bowel management for spinal cord injury patients. Spinal Cord. 2008; 47(2):138-43. DOI: 10.1038/sc.2008.98. View

11.

Musco S, Bazzocchi G, Martellucci J, Amato M, Manassero A, Putignano D . Treatments in neurogenic bowel dysfunctions: evidence reviews and clinical recommendations in adults. Eur J Phys Rehabil Med. 2020; 56(6):741-755. DOI: 10.23736/S1973-9087.20.06412-6. View

12.

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. DOI: 10.1016/j.pmr.2020.04.003. View

13.

Emmanuel A, Kurze I, Krogh K, Ferreiro Velasco M, Christensen P, Del Popolo G . 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. PMC: 7845961. DOI: 10.1371/journal.pone.0245453. View