Results of the cost-effectiveness (CE) and cost-utility analysis
| Effect outcome | ΔE (95% CI) | ΔC (95% CI) | ICER | Proportion of bootstrapped cost–effect pairs in the CE-plane | |||
| NE | SE | SW | NW | ||||
| Main analysis—healthcare perspective | |||||||
| PGI-I, n=439 | −0.05 (−0.14; 0.03) | −1807 (−2172; −1446) | 33 509 | 0% | 9% | 91% | 0% |
| QALY, n=439 | −0.03 (−0.07; 0.002) | −1807 (−2172; −1446) | 52 980 | 0% | 3% | 97% | 0% |
| Main analysis—societal perspective | |||||||
| PGI-I, n=439 | −0.05 (−0.14; 0.03) | −1850 (−2349; −1341) | 34 295 | 0% | 9% | 91% | 0% |
| QALY, n=439 | −0.03 (−0.07; 0.002) | −1850 (−2349; −1341) | 54 223 | 0% | 3% | 97% | 0% |
| Sensitivity analysis 1: complete case analysis—healthcare perspective | |||||||
| PGI-I, n=259 | −0.02 (−0.11; 0.07) | −1976 (−2460; −1585) | 81 560 | 0% | 25% | 75% | 0% |
| QALY, n=256 | −0.01 (−0.05; 0.03) | −1962 (−2470; −1572) | 236 907 | 0% | 33% | 67% | 0% |
| Sensitivity analysis 1: complete case analysis—societal perspective | |||||||
| PGI-I, n=254 | −0.02 (−0.11; 0.08) | −1884 (−2499; −1241) | 99 339 | 0% | 30% | 70% | 0% |
| QALY, n=252 | −0.005 (−0.05; 0.04) | −1860 (−2500; −1225) | 367 444 | 0% | 39% | 61% | 0% |
| Sensitivity analysis 2: per-protocol analysis—healthcare perspective | |||||||
| PGI-I, n=271 | −0.13 (−0.25; −0.01) | −4398 (−4583; −4311) | 33 044 | 0% | 1% | 99% | 0% |
| QALY, n=271 | −0.01 (−0.05; 0.02) | −4398 (−4583; −4311) | 358 020 | 0% | 27% | 73% | 0% |
| Sensitivity analysis 2: per-protocol analysis—societal perspective | |||||||
| PGI-I, n=271 | −0.13 (−0.25; −0.01) | −4748 (−5159; −4498) | 35 676 | 0% | 1% | 99% | 0% |
| QALY, n=271 | −0.01 (−0.05; 0.02) | −4748 (−5159; −4498) | 386 539 | 0% | 27% | 73% | 0% |
ΔC=difference in costs in €; ΔE=difference in effects; ICER=€ per unit of effect gained; CE-plane=CE plane showing the difference in costs between pessary therapy and surgery on the y-axis and the difference in effects on the x-axis resulting in four quadrants, namely, NE=pessary therapy more expensive and more effective than surgery; SE=pessary therapy less expensive and more effective than surgery; SW=pessary therapy less expensive and less effective than surgery; NW=pessary therapy more expensive and less effective than surgery. The PGI-I model was adjusted by risk-increasing aspects and prolapse stage. The QALY model was adjusted by baseline utility values, risk-increasing aspects and prolapse stage. Healthcare and societal costs models were adjusted by age, menopause state, risk-increasing aspects and prolapse stage. PGI-I is presented as the difference between groups in the proportion of participants reporting improvement.
ICER, incremental cost-effectiveness ratio; NE, northeast; NW, northwest; PGI-I, Patient Global Impression of Improvement; QALY, quality-adjusted life-year; SE, southeast; SW, southwest.