Assessing the Value of PureWick™ for Female Urinary Incontinence in Non-Acute Settings: Multi-Country Cost-Effectiveness and Budget Impact Analyses

Introduction: Urinary incontinence (UI) imposes a substantial clinical and economic burden. The PureWick™ device is a non-invasive alternative for women to pads/diapers and indwelling catheters, but its value has never been assessed internationally. We aimed at estimating the cost-utility and budget impact of introducing PureWick in nursing-home and home-care settings in Belgium, France, Germany, Italy, The Netherlands, Spain and the UK. Methods: A 1-year decision model compared PureWick + pad with pad alone from the payer perspective (National Health Service-NHS/Personal Social Services). Model inputs were derived from a targeted literature review, national tariffs and manufacturer data; gaps were filled by expert judgement. The expected outcomes included quality-adjusted life years (QALYs), costs for each strategy and incremental cost-utility ratios (ICURs). Parameter uncertainty was explored with both deterministic and probabilistic sensitivity analyses. A dynamic budget-impact model projected per-patient costs over 3 years considering an increasing uptake (from 5 to 15%) of PureWick over pads. Results: Relative to pads alone, PureWick + pad provided more QALYs (0.7792 vs. 0.7790) at lower cost, resulting in a cost-saving strategy in all country-setting combinations. In these countries, budget-impact modelling predicted per-patient savings of 29-1071€ and 77-2354€ in nursing home and home-care settings, respectively. The probabilistic sensitivity analysis confirmed the robustness of the model results across different countries and settings. The most influential parameters were unit cost and daily usage rate of the devices, nursing time requirements and the associated cost of nursing care. Conclusion: Across the countries and care settings analyzed, PureWick combined with pads was a dominant strategy compared with pads alone. Policy makers should consider its inclusion in continence-care pathways while supporting real-world evidence collection to confirm long-term effectiveness, usage patterns and uptake assumptions.