A mobile app for the treatment of female mixed and urgency incontinence: a cost-effectiveness analysis in Sweden

Introduction and hypothesis A previous randomized controlled trial (RCT) demonstrated that the app Tat II, for self-management of mixed urinary incontinence (MUI) and urgency urinary incontinence (UUI), yielded significant, clinically relevant improvements in symptom severity and quality of life (QoL) compared with a control group. We aimed to assess the cost-effectiveness of Tat II. Methods A cost-utility analysis with a 1-year societal perspective was carried out, comparing Tat II with an information app. Data were collected alongside an RCT: 122 community-dwelling women aged >= 18 years with MUI or UUI >= 2 times/week were randomized to 3 months of Tat II treatment focused on pelvic floor muscle training (PFMT) and bladder training (BT; n = 60), or to an information app (n = 62). Self-assessed data from validated questionnaires were collected at baseline and at 3-month and 1-year follow-ups. Costs for assessment, treatment delivery, incontinence aids, laundry, and time for PFMT and BT were included. We calculated quality-adjusted life-years (QALYs) using the International Consultation on Incontinence Modular Questionnaire Lower Urinary Tract Symptoms Quality of Life. The incremental cost-effectiveness ratio (ICER) between the groups was our primary outcome. Sensitivity analyses were performed. Results The mean age was 58.3 (SD = 9.6) years. Annual overall costs were euro738.42 in the treatment group and euro605.82 in the control group; annual QALY gains were 0.0152 and 0.0037 respectively. The base case ICER was euro11,770.52; ICERs in the sensitivity analyses ranged from euro-9,303.78 to euro22,307.67. Conclusions The app Tat II is a cost-effective treatment method for women with MUI and UUI.