Cost-Comparison Analysis of APEX M™ Pelvic Floor Therapy for the Treatment and Management of Female Urinary Incontinence

Abstract

The primary objective of this study was to assess the efficacy of APEX M™ pelvic floor therapy, a pelvic stimulating device, for women with urinary incontinence (UI) from April 1, 2014 to January 31, 2018 at a tertiary medical center. Efficacy of the device was measured by daytime incontinence episodes; nighttime incontinence episodes (nocturia); number of female incontinence pads at study visits. A total of 47 women purchased the device and participated in a treatment protocol. A total of 71 women purchased the device online or over the counter and did not participate in the treatment protocol. A secondary objective was to assess health-related direct costs of UI including prescription medications, pelvic floor physical therapy sessions, surgical interventions, and female incontinence pads in patients who used APEX M™ and those who didn't use the device. Health care resource utilization and costs were calculated for women who purchased APEX M™ (47 women) and participated in a treatment protocol as well as for those who were eligible to benefit from the use of the pelvic stimulating device but chose not to purchase it (236 women). Wilcoxon signed-rank tests showed that daytime incontinence episodes, nocturia, and number of pads used had significant decreases from the initial to follow-up visits (day incontinence episodes P<0.001, episodes of nocturia P<0.001 and number of pads P=0.014). More cost-effective and conservative approaches are becoming more common in the treatment of UI. The results of this study may be useful in shared-decision making with your patients regarding the most appropriate, cost-effective and less-invasive treatment for female urinary incontinence.