Mp57-12 Cost Analysis of Oral Phenazopyridine Versus Intravesical Lidocaine for Pre- Procedural Analgesia for Intradetrusor Onabotulinumtoxina Injections

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes II (MP57)1 May 2024MP57-12 COST ANALYSIS OF ORAL PHENAZOPYRIDINE VERSUS INTRAVESICAL LIDOCAINE FOR PRE- PROCEDURAL ANALGESIA FOR INTRADETRUSOR ONABOTULINUMTOXINA INJECTIONS Anjali Kapur, Rui Wang, Lauren Stewart, and Moiuri Siddique Anjali KapurAnjali Kapur , Rui WangRui Wang , Lauren StewartLauren Stewart , and Moiuri SiddiqueMoiuri Siddique View All Author Informationhttps://doi.org/10.1097/01.JU.0001009420.83948.eb.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Office intradetrusor onabotulinumtoxinA (BTX) injection is often used to treat refractory idiopathic overactive bladder (OAB), with 245,942 procedures performed in the US in 2022 for this indication alone (AbbVie). Common pre-procedure analgesic agents include a 20-30 minute instillation of 50 cc 2% intravesical lidocaine (LID) or oral phenazopyridine (PYR) 200 mg taken 1-2 hours prior. PYR is associated with shorter appointment times and is non-inferior to LID for pain control during BTX procedures, with >90% of queried patients reporting adequate analgesia with either agent (Stewart et al., 2022). Our objective was to perform a cost analysis of PYR versus LID for analgesia before BTX for OAB. METHODS: A healthcare sector-perspective cost analysis was performed. Our model made the following assumptions: 1) similar efficacy of PYR and LID in providing adequate analgesia, 2) similar physician ease of performing BTX with either analgesic, and 3) similar patient satisfaction with either analgesic. Average cost of medications, adverse reactions, nursing tasks, and office visit time were found in publicly available consumer data reported in 2023 USD (Table 1). Sensitivity analyses were performed by varying these parameters using TreeAge Pro 2021, R1 software. RESULTS: PYR is less costly than LID per visit for BTX ($827.28 vs. $925.22, respectively), a difference of $97.94 per procedure. This provides a total annual cost savings of over $24 million if all procedures are performed with PYR instead of LID. Threshold sensitivity analysis over wide ranges of input values revealed PYR no longer provides a cost saving when the cost of a BTX office visit is below $362.54 with LID or above $430.40 with PYR (Figure 1). PYR is no longer cost saving when: 1) cost of a pre-procedure nursing telephone reminder for PYR consumption is above $338.94, 2) cost of adverse reaction to LID is below $4385.15, or 3) cost of adverse reaction to PYR is above $4312.27. CONCLUSIONS: PYR provides significant cost savings compared to LID for analgesia during intradetrusor BTX injections for refractory idiopathic OAB. If adopted by providers nationwide, this could reduce healthcare spending and minimize time-consuming office visits while maintaining patient pain control and satisfaction. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e942 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Anjali Kapur More articles by this author Rui Wang More articles by this author Lauren Stewart More articles by this author Moiuri Siddique More articles by this author Expand All Advertisement PDF downloadLoading ...