FP131
COST ANALYSIS OF INCREASED WATER INTAKE ON RECURRENT CYSTITIS BASED ON RESULTS FROM A RANDOMIZED CLINICAL TRIAL Free

INTRODUCTION: Cystitis is a common and expensive condition that impacts women and society. In the current abstract we aim to determine the cost savings of an increased water intake strategy for the prevention of recurrent cystitis in premenopausal women.

METHODS: The cost benefit of hydration versus standard fluid intake was assessed as a secondary objective in a prospective randomized trial of premenopausal women who are low drinkers with recurrent UTIs. 140 healthy premenopausal women were randomly assigned to drink additional 1.5 liters of water or to maintain their usual fluid intake. A health care cost questionnaire related to the UTI event was completed at the end of every symptomatic event confirmed by positive urine culture. Data on cost of UTI were obtained from the literature for 9 countries. Differences of cost between the two treatment groups were used to extrapolate potential cost difference by implementing increased fluid intake for prevention of UTIs.

RESULTS: In the randomized trial, cystitis episodes were significantly reduced at the end of the 12-month period in the group with increased water intake. Overall, there were 327 cystitis episodes, 111 in WG and 216 in CG over 12-month study period. The estimated mean annual number of antimicrobial regimens used to treat cystitis episodes was 1.9 (95% CI, 1.7-2.2) in WG compared with 3.6 (95% CI, 3.3-4.0) in CG (p<0.001).   Loss of work was 69 days and 139 days in the water group and control group, respectively for an average of 0.63 days per UTI.  On an individual basis a significant cost savings ranged from 126 BGN in Bulgaria to $540 in US per patient.  Annual target population cost savings in different countries were significant, with over $100 million in US and tens of millions of Euros in countries such as France and Italy.

CONCLUSIONS: Increased water intake reduced risk of recurrent UTIs in premenopausal women who are low drinkers.  This has a direct reduction in rate of antibiotic use and loss of work.  This has significant financial implications on a per patient and societal basis.