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. 2014 Jan;62(1):111-6.
doi: 10.1111/jgs.12595.

Cost-effectiveness of cranberry capsules to prevent urinary tract infection in long-term care facilities: economic evaluation with a randomized controlled trial

Wilbert B van den Hout, Monique A A Caljouw, Hein Putter, Herman J M Cools, Jacobijn Gussekloo

Cost-effectiveness of cranberry capsules to prevent urinary tract infection in long-term care facilities: economic evaluation with a randomized controlled trial

Wilbert B van den Hout et al. J Am Geriatr Soc. 2014 Jan.

Abstract

Objectives: To investigate whether the preventive use of cranberry capsules in long-term care facility (LTCF) residents is cost-effective depending on urinary tract infection (UTI) risk.

Design: Economic evaluation with a randomized controlled trial.

Setting: Long-term care facilities.

Participants: LTCF residents (N = 928, 703 female, median age 84), stratified according to UTI risk.

Measurements: UTI incidence (clinically or strictly defined), survival, quality of life, quality-adjusted life years (QALYs), and costs.

Results: In the weeks after a clinical UTI, participants showed a significant but moderate deterioration in quality of life, survival, care dependency, and costs. In high-UTI-risk participants, cranberry costs were estimated at €439 per year (1.00 euro = 1.37 U.S. dollar), which is €3,800 per prevented clinically defined UTI (95% confidence interval = €1,300-infinity). Using the strict UTI definition, the use of cranberry increased costs without preventing UTIs. Taking cranberry capsules had a 22% probability of being cost-effective compared with placebo (at a willingness to pay of €40,000 per QALY). In low-UTI-risk participants, use of cranberry capsules was only 3% likely to be cost-effective.

Conclusion: In high-UTI-risk residents, taking cranberry capsules may be effective in preventing UTIs but is not likely to be cost-effective in the investigated dosage, frequency, and setting. In low-UTI-risk LTCF residents, taking cranberry capsules twice daily is neither effective nor cost-effective.

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Figures

Figure 1
Figure 1
The state-transition model used in the economic evaluation. UTI = Urinary Tract Infection.
Figure 2
Figure 2
Cost-effectiveness acceptability curves, for high-urinary tract infection (UTI)-risk participants (the probability that cranberry use is more cost-effective than placebo, depending on how much one is willing to pay for a quality-adjusted life year (QALY), based on utility measured using the EQ-5D or the visual analog scale (VAS)).
See this image and copyright information in PMC

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References

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