A retrospective claims analysis of the direct costs of stress urinary incontinence

The aim of this study was to evaluate direct expenditures associated with urinary incontinence and overall medical expenditures incurred by women diagnosed with stress urinary incontinence (SUI). The study design was a retrospective analysis of administrative claims data. We identified women with a diagnosis of SUI and no stress, urge or mixed urinary incontinence in the preceding 12 months using the MarketScan 1996-1999 databases. Total expenditures, as well as urinary incontinence-related expenditures, were summarized during the 12 months before and after the initial SUI diagnosis. We also compared expenditures for SUI patients receiving surgical treatment to expenditures for those who did not. There were 8126 patients who met the eligibility criteria. Total healthcare expenditures in the year prior to the initial SUI diagnosis were approximately half of those in the year following the initial diagnosis ($4478 vs $9147). For the subset of patients treated with surgery there was a threefold increase ($4575 vs $14129) in costs. A sensitivity analysis in patients with no comorbid urinary diagnoses found somewhat lower costs but a similar rate of increase in costs between the pre-period and the study period ($3884 vs $7075). Among women with no comorbid urinary diagnoses, approximately 11% ($769; SD $1180) of total mean regression-adjusted annual expenditures ($6892; SD $5067) was attributable to UI. Predicted total expenditures for surgery patients without comorbid urinary diagnoses were $13 212 (SD $7967), 28% of which ($3640;SD $681) were for UI-related costs. We concluded that after diagnosis, annual expenditures for patients were roughly twice those in the year prior to diagnosis. Multivariate analysis suggests that in the year after SUI diagnosis, UI treatment costs represented approximately 10% of total expenditures for all SUI patients, and 26%-28% of total expenditures for the subset of surgically treated patients.