Cost effectiveness analysis of fesoterodine compared to mirabegron in first-line therapy setting for overactive bladder with urge urinary incontinence, from the Spanish National Health System perspective

Angulo, Javier; Sánchez-Ballester, F.; Peral, Carmen; Rejas, Javier; Ramos, Jaime Alberto Valencia; Snedecor, Sonya J.; Sudharshan, Lavanya; Liu, S.; Luo, Xuemei

doi:10.1016/j.acuroe.2016.07.006

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…In different economic evaluations with fesoterodine published in Spain, where a CEA has been performed, the superiority of fesoterodine has been shown, compared with other drugs for the symptomatic treatment of OAB. 17 – 19 These economic evaluations have shown that, compared with solifenacin, tolterodine or mirabegron, fesoterodine has an ICER under the cost-effectiveness threshold normally accepted in Spain for inclusion in the pharmaceutical services of NHS. 25 The economic superiority of fesoterodine compared with other antimuscarinic drugs available in our health care setting has also been shown in conditions of routine or real-life practice, indicating that fesoterodine can lead to health care savings in the treatment of OAB, which is NHS-funded, and offsetting its higher pharmacological cost with less use of health care resources, such as medical visits, absorbents, or concomitant medication related to OAB (antidepressants, anxiolytics, etc), in patients of any age and in vulnerable subjects.…”

Section: Discussionmentioning

confidence: 99%

“…However, this might not be a significant problem from an economic point of view, as has been observed in other economic evaluations carried out in our health care setting with antimuscarinic drugs. 17 – 19 Finally, this evaluation was not performed from the society’s perspective, because this study did not take into account variables such as payment for absorbents by the patient, travel costs, losses in productivity, or their impact on indirect costs.…”

Section: Discussionmentioning

confidence: 99%

“…Given the limited health care resources of the National Health Service (NHS), economic evaluations of cost-effectiveness provide evidence for deciding on the most appropriate use of resources. To date, economic evaluations with antimuscarinic drugs have not addressed the cost-effectiveness of flexible doses, 17 – 19 despite this being a routine practice in the treatment of these patients in real life. 16 Therefore, the purpose of this study is to conduct a cost-effectiveness analysis (CEA) from the perspective of Spain’s NHS.…”

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness analysis of fesoterodine flexible dose in newly diagnosed patients with overactive bladder in routine clinical practice in Spain

Peral

Sánchez-Ballester

García-Mediero

et al. 2016

CEOR

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ObjectiveTo carry out cost-effectiveness analysis from the Spanish National Health System perspective, of treating overactive bladder (OAB), in newly diagnosed patients with two flexible doses of fesoterodine in routine clinical practice.Patients and methodsEconomic evaluation of flexible-dose fesoterodine in newly diagnosed patients, including two treatment groups: standard escalating from 4 to 8 mg or fast escalating to 8 mg. Costs were estimated from health care resources utilization related to OAB, and were expressed in 2015 Euros. Quality-adjusted life-years (QALYs) were obtained from overactive bladder questionnaire-short form. Univariate and probabilistic sensitivity analyses were carried out.ResultsThree hundred and ninety symptomatic OAB patients treated with fesoterodine and newly diagnosed (141 in fast escalating group and 249 in standard escalating) were analyzed. Adjusted health care total costs were not statistically different; difference −€4.1 (confidence interval: −153.3; 25.1) P=0.842. QALYs were higher in fast escalating to high dose vs standard escalating group, resulting in a cost of −€16,020/QALY gained for fast escalating vs standard escalating group.ConclusionWhen the cost-effectiveness threshold is set at a maximum value of €30,000/QALY gained, fesoterodine fast escalating group was cost-effective vs standard escalating group 67.6% of the time. The treatment with fesoterodine, in female patients newly diagnosed, fast escalating to 8 mg was a cost-effective option relative to escalating traditionally from 4 to 8 mg, in the management of OAB in routine clinical practice, from the Spanish National Health System perspective.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness analysis of fesoterodine flexible dose in newly diagnosed patients with overactive bladder in routine clinical practice in Spain

Peral

Sánchez-Ballester

García-Mediero

et al. 2016

CEOR

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Mirabegron: A Review in Overactive Bladder Syndrome

Deeks

2018

Drugs

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The first-in-class β-adrenoceptor agonist mirabegron is indicated in the EU (Betmiga™), Japan (Betanis™) and several other countries for the management of overactive bladder (OAB) syndrome. Evidence for its use in this setting includes several large phase 3 trials. Compared with placebo, oral mirabegron for 12 weeks reduced the frequency of micturition and generally also that of incontinence, with other benefits including reduced urgency, increased void volume and improved health related quality-of-life (HR-QOL). Mirabegron comparisons versus tolterodine are descriptive; however, in a 12-week powered comparison versus solifenacin in patients dissatisfied with antimuscarinic efficacy, mirabegron did not demonstrate noninferiority in reducing micturition frequency or significantly differ in terms of improving other urinary symptoms. Urinary and HR-QOL benefits of mirabegron were sustained over up to 52 weeks of treatment and the drug was generally well tolerated, with a numerically lower incidence of dry mouth than antimuscarinics. Real-world data support the trial findings and indicate possible persistence and adherence benefits for mirabegron over antimuscarinics. Mirabegron use is not generally restricted by patient age, sex or antimuscarinic treatment status, although data in men (from a phase 4 study and phase 3 trial subanalyses) are variable; additional studies in older and male OAB patients are awaited with interest. Although further longer-term efficacy and tolerability data would be beneficial, current clinical evidence indicates that mirabegron provides an alternative to antimuscarinics for the management of OAB in adults, including those for whom antimuscarinics have proven unsuitable.

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Cost-effectiveness evaluation of mirabegron versus anti-muscarinics and third-line therapies: a systematic review

Mohammadnezhad

Azadmehr

Yousefi

2022

Expert Review of Pharmacoeconomics & Outcomes Research

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Cost effectiveness analysis of fesoterodine compared to mirabegron in first-line therapy setting for overactive bladder with urge urinary incontinence, from the Spanish National Health System perspective

Cited by 4 publications

References 29 publications

Cost-effectiveness analysis of fesoterodine flexible dose in newly diagnosed patients with overactive bladder in routine clinical practice in Spain

Cost-effectiveness analysis of fesoterodine flexible dose in newly diagnosed patients with overactive bladder in routine clinical practice in Spain

Mirabegron: A Review in Overactive Bladder Syndrome

Cost-effectiveness evaluation of mirabegron versus anti-muscarinics and third-line therapies: a systematic review

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