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"Cost-Effectiveness of Sacral Neuromodulation versus OnabotulinumtoxinA for Refractory Urgency Urinary Incontinence: Results of the ROSETTA Randomized Trial"
Harvie, H. S., Amundsen, C. L., Neuwahl, S. J., Honeycutt, A. A., Lukacz, E. S., Sung, V. W., Rogers, R. G., Ellington, D., Ferrando, C. A., Chermansky, C. J., Mazloomdoost, D., & Thomas, S. (2020). Reply by authors: "Cost-Effectiveness of Sacral Neuromodulation versus OnabotulinumtoxinA for Refractory Urgency Urinary Incontinence: Results of the ROSETTA Randomized Trial". Journal of Urology, 203(5), 977. https://doi.org/10.1097/JU.0000000000000656.02
Subsequent to the publication of the guideline by Gormley et al (reference 10 in article) several studies have reported continued BTX efficacy and improved quality of life while maintaining the same median inter-injection intervals beyond 2-year followup.1-3 Causes for therapy discontinuation are most accurately reported in prospective studies. Thus, as referenced in the comment, the 3.5-year followup in the study by Nitti et al showed that 5.7% of discontinuations were due to lack of efficacy and the highest rate, 12%, was due to trial burden.4 For the 22 BTX participants who did not complete the study protocol a sensitivity analysis showed that assuming maximum BTX costs for all would raise 2-year BTX costs to almost $13,000, compared to 2-year SNM costs of $35,680 (supplementary Appendix C, https://www.jurology.com ).
