Recurrent urinary tract infections (UTIs) impose a significant burden on both patients and healthcare systems, leading to increased healthcare costs and a diminished quality of life. MV140 (Uromune) is a once daily polybacterial sublingual vaccine composed of inactivated whole bacteria, including Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, and Proteus mirabilis. Previous studies have demonstrated that MV140 effectively reduces UTI recurrence rates.

This study aims to evaluate the real-life cost savings associated with MV140 in the management of recurrent UTIs within the UK healthcare system. To our knowledge, this is the first study assessing the financial impact of MV140 in this setting.

A retrospective analysis was conducted on the initial 2017 cohort of Berkshire patients with microscopy, culture, and sensitivity (MC&S) confirmed recurrent UTIs who received MV140 treatment.  Data were collected from general practice (GP) and electronic patient records for 24 months; 12 months preceding and following MV140 administration.

Cost data for GP consultations, medications, and investigations were sourced from the British National Formulary (BNF) and the King's Fund databases.  The statistical significance of cost reductions following treatment was assessed using a Wilcoxon Signed-Rank Test performed in Microsoft Excel.

10 female patients with recurrent UTIs were identified and assessed.  The average age was 66.8 years (range: 51–87), and the mean Charlson Comorbidity Index was 3 (range: 1–7).

In the 12 months preceding MV140 administration, the total cost of UTI-related treatments was £3,937.37, with a mean cost of £393.74 per patient (range: £195.22–£848.23).  Each patient experienced three or more UTIs (range: 3–8) and used an average of £52.67 (range: £2.74–£113.91) on antibiotics for acute treatment and/or low-dose prophylaxis.  Patients also utilised on average 5.3 general practitioner (GP) consultations (range: 3–11), totalling £2,968 in GP utilisation costs. No hospital admissions were required.

In the 12 months following MV140 treatment, 7 patients (70%) remained UTI-free. The mean number of UTI episodes decreased to 1.4 (range: 0–7).  GP consultations decreased by 68% to an average of 1.7 per patient (range: 0–7). Total UTI-related treatment costs were reduced by 66% to £1,344.67 (mean: £134.47 per patient, range: £0.00–£496.65). Antibiotic costs decreased by 70% to a mean of £16.01 per patient (range: £3.38–£90.37).

The overall cost saving per patient at 12 months was £259.27, equivalent to £21.61 per month. This cost reduction was statistically significant (p = 0.0059), as illustrated in Figure 1.

MV140 demonstrates promise in the management of recurrent UTIs. However, within the UK's publicly funded National Health Service, the observed cost savings over 12 months are less substantial than initially projected. This is primarily attributable to the relatively low cost of primary care consultations (currently only £56 per 10-minute face-to-face appointment) and the affordability of standard UTI treatments, including antibiotics and diagnostic testing, compared with the initial investment required for novel therapies.

While the 12-month cost benefits appear modest in the UK context, the long-term cost-effectiveness of MV140 may be more significant, given the growing evidence showing sustained efficacy beyond this timeframe.  Furthermore, improvements in patients' quality of life, a reduction in antibiotic usage, and increased productivity due to fewer sick days represent important, albeit difficult-to-quantify, benefits.  Conversely, in healthcare systems with predominantly private funding models, where consultation and treatment costs are typically higher, the cost-effectiveness of MV140 may be more pronounced.