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Lookup NU author(s): Dr Thomas ChadwickORCiD, Nicola GoudieORCiD, Gillian WatsonORCiD, Dr Nina WilsonORCiD, Ruth Wood
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author(s) 2026.Objectives: Widespread adoption of single-use intermittent catheters for bladder drainage has led to increased costs and environmental waste. Reusable catheters could reduce both. The MultICath study showed that combined reusable and single-use catheters (Mixed-use) was non-inferior to single-use catheters for urinary tract infection and quality of life, but the economic impact is unknown. We aim to determine whether Mixed-use is cost-effective compared to Single-use only. Methods: Cost-utility and cost-consequence analyses were conducted alongside MultICath. The analysis took the United Kingdom payer perspective, using individual patient-level data of the 578 randomised (1:1) trial participants over 12 months. Costs included catheter and cleaning costs, antibiotic costs, and health-related visit costs. Outcomes were measured in quality adjusted life years (QALYs), estimated from EQ-5D-5L data. Incremental, sensitivity, and scenario analyses were conducted. Results: Mixed-use participants used on average 902 (95% CI 755.13; 1049.31) fewer single-use catheters per annum than Single-use participants. Mixed-use was cost-effective in all analyses. Base-case annual incremental cost savings were -£1348.82 (95% CI -1939.98; -757.65) whilst incremental QALYs were negligible (-0.001; [-0.026; 0.024]). These estimates produced a positive net monetary benefit of £1328.82 at a willingness-to-pay threshold of £20,000. The probability of Mixed-use being cost-effective was never below 96.6%. The primary limitation was differential withdrawal rates between groups, accounted for in sensitivity analyses. Conclusions: Mixed-use is cost-effective for the UK National Health Service, and provision of reusable catheters should be considered. These findings are also relevant for other health services worldwide with high single-use catheter costs.
Author(s): McCloskey S, Sach TH, Macaulay M, Avery MR, Chadwick TJ, Clancy B, Dickson S, Goudie N, Guerrero K, Hagen S, Murphy C, Watson GC, Wilson N, Wood R, Fader M
Publication type: Article
Publication status: Published
Journal: Cost Effectiveness and Resource Allocation
Year: 2026
Volume: 24
Issue: 1
Online publication date: 09/05/2026
Acceptance date: 22/04/2026
Date deposited: 08/06/2026
ISSN (electronic): 1478-7547
Publisher: BioMed Central Ltd
URL: https://doi.org/10.1186/s12962-026-00750-z
DOI: 10.1186/s12962-026-00750-z
Data Access Statement: Consent was not obtained from participants for data sharing. Authors will consider reasonable request to make relevant anonymised participant level data available.
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