Healthcare Costs Associated With Hydrophilic-Coated and Non-Coated Urinary Catheters For Intermittent Use in the United States

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Intermittent catheterization is today considered as the “gold standard” for treatment of urinary retention. In the United States, all intermittent urinary catheters with the same HCPCS code covered in an insurance plan are reimbursed at the same level, although the amount of reimbursement can differ from plan to plan. However, clinical evidence proposes efficacy differences between catheter types.


To perform a health economic evaluation in the U.S. healthcare system comparing hydrophilic-coated to noncoated catheters among users of intermittent catheterization.


A Markov model simulating a population of 40-year-old users of intermittent catheterization was developed based on U.S.-specific cost data from the literature. The simulated population was modelled to use either a hydrophilic-coated or a non-coated catheter four times per day. Catheters within the HCPCS code A4351, reimbursed with $1.89 each, were compared.


Modelling a lifetime use of intermittent catheterization starting at age 40 years resulted in both substantial healthcare costs and complications for the patient. The use of hydrophilic-coated instead of non-coated catheters avoided on average 18 complications per patient, which translated into a total cost saving for the healthcare system of $10,184 per patient.


At the same reimbursement level, the hydrophilic-coated catheter was found to result in both health benefits and substantial cost savings compared to the non-coated catheter. This implies that hydrophilic-coated catheters should be the first and standard choice for those who are prescribed intermittent catheterization.


Level of Evidence - Level III


(Polit & Beck, 2012)


Håkansson, M.Å., Neovius, K., & Lundqvist, T. (2016). Healthcare costs associated with hydrophilic-coated and non-coated urinary catheters for intermittent use in the United States.


This health economic evaluation simulated a cohort to compare hydrophilic-coated to non-coated catheters for intermittent catheterization. By using a Markov model, lifetime costs and catheter-related complications were investigated. Results determined that the use of hydrophilic-coated catheters save money and reduce treatment-related complications.

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