Health economic analysis of a urinary catheter which reduce the frequency of urinary tract infections (UTIs) Research questions: a) What is the willingness-to-pay (WTP) in Sweden - from a patient perspective - for a urinary catheter which reduce the annual frequency of urinary tract infections by 25% and 50%, respectively, and (b) is the WTP dependent on the annual frequency of UTIs and gender?

Abstract

Objective: To investigate the preference for urinary catheters that can reduce the frequency of urinary tract infections (UTIs), among Swedish patients practicing clean intermittent catheterization (CIC), and analyze if the preference is affected by the frequency of UTIs and gender. Methods: The preference for a clinically more effective catheter was expressed as a monetary value by investigating the patients’ willingness-to-pay (WTP) to switch catheters. The results were stratified on annual frequency of UTIs and gender. An electronic questionnaire was sent by e-mail to 144 Swedish users of intermittent catheters. The participants were asked to assume a situation in which they use their current catheter but had the choice to switch to a similar catheter, which hypothetically would reduce the frequency of UTIs including possible complications. Either every fourth or every second UTI could be avoided. The participants were asked to report their frequency of UTIs and their willingness-to-pay for the new catheter was collected by letting them choose to spend either one of eleven explicit monthly amounts from 0–1000 SEK or any other amount in an open answer. Only individuals stating that they were ‘certain’ or ‘very certain’ regarding their answers were included in the analyses. Statistical analyses were performed with non-parametric testing methods. Results: 96 individuals returned the questionnaire, of which 42 males and 28 females were certain or very certain regarding their answers. The proportion of respondents with ≤1 UTI/year and ≥2 UTI/year was 74% and 26%, respectively. The respondents were willing to spend on average 120 SEK each month to avoid every fourth UTI and 174 SEK each month to avoid every second UTI. The results to avoid every fourth and every second UTI, respectively, showed no difference between men and women but having ≥2 UTI/year reached statistical significance. Conclusion The CIC users in this study, who practice intermittent catheterization on a daily basis, expressed a preference for catheters that could help to decrease the frequency of urinary tract infections as expressed by a willingness to pay for more effective catheters. The result was dependent on the annual frequency of UTIs but not gender.