Costs Associated with the Management of Overactive Bladder and Related Comorbidities

Darkow, Theodore; Fontes, Christina L.; Williamson, Todd

doi:10.1592/phco.25.4.511.61033

Cited by 88 publications

(101 citation statements)

References 24 publications

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“…In turn, increased medical requirements necessitated by either suboptimal treatment or potentially avoidable chronic disease sequelae lead to increased costs, increased health care utilization, and increased susceptibility to adverse drug reactions. [27][28][29][30][31][32][33][34][35][36] In a longitudinal cohort study conducted by Balkrishnan et al (2006), OAB patients experienced a 5.6% reduction in annual health care costs for every 10% increase in MPR. 36 By comparing across 6 chronic therapeutic areas, the present study confirms that room for improvement in drug persistence and adherence exists across a range of conditions.…”

Section: ■■ Conclusionmentioning

confidence: 99%

Comparing Adherence and Persistence Across 6 Chronic Medication Classes

Yeaw¹,

Benner²,

Walt³

et al. 2009

JMCP

495

382

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Section: ■■ Conclusionmentioning

confidence: 99%

Comparing Adherence and Persistence Across 6 Chronic Medication Classes

Yeaw¹,

Benner²,

Walt³

et al. 2009

JMCP

495

382

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show abstract

“…11 Depression is strongly associated with OAB. [14][15][16] OAB patients become anxious in unfamiliar surroundings: they focus on and may be preoccupied with such concerns as locating the closest bathroom, looking for aisle seating, and estimating the amount of time until their next work break. 14,17 Embarrassment, frustration, anxiety, annoyance, depression, and fear of odor can have a negative impact on daily activities, such as travel, physical activity, interpersonal relationships, and sexual function, resulting in social isolation.…”

Section: Socioeconomic Burden Quality Of Life and Social Impactmentioning

confidence: 99%

Social, economic, and health utility considerations in the treatment of overactive bladder

Sacco

Tienforti²,

D’Addessi³

et al. 2010

RRU

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Overactive bladder (OAB) is a highly prevalent urinary syndrome with a profound impact on quality of life (QoL) of affected patients and their family because of its adverse effects on social, sexual, interpersonal, and professional function. Cost-of-illness analyses showed the huge economic burden related to OAB for patients, public healthcare systems, and society, secondary to both direct and indirect costs; however, intangible costs related to QoL impact are usually omitted from these analyses. Recently many novel treatment modalities have been introduced and the need to apply the modern methodology of health technology assessment to these treatment strategies was immediately clear in order to evaluate objectively their value in term of both improvement in length/quality of life and costs. Health utilities are instruments that allow a measurement of QoL and its integration in the economic evaluation using the quality-adjusted life-years model and cost-utility analysis. The development of suitable instruments for quantifying utility in the specific group of OAB patients is vitally important to extend the application of cost-utility analysis in OAB and to guide healthcare resources allocation for this disorder. Studies are required to define the cost-effectiveness of available pharmacological and nonpharmacological therapy options for this disorder.

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“…9 In addition, it has been shown that the prevalence of depression in those with OAB is two-fold higher than in the general population (10.5% vs. 4.9%, respectively; p<0.0001). 10 At a societal level, OAB is associated with substantial healthcare costs. In Canada, the total excess cost attributed to OAB, excluding nursing care and lost productivity, was approximately $576 000 000 in 2009; this rose to over $640 000 000 when lost productivity was taken into account.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of mirabegron compared to tolterodine ER 4 mg for overactive bladder in Canada

Herschorn¹,

Nazir²,

Ramos³

et al. 2017

CUAJ

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Introduction: This analysis compared the cost-effectiveness of once-daily regimens of mirabegron 50 mg and generic tolterodine ER 4 mg in a hypothetical cohort of previously treated patients with overactive bladder (OAB) in Canada. Methods: A Markov model was developed to represent different health states according to OAB symptoms (frequency, incontinence), presence/absence of adverse events (AEs; dry mouth, constipation, blurred vision), and treatment status (on-treatment, discontinue treatment, restart previous treatment). The time horizon used was one year, with monthly transitions between health states. The model was populated using data from a phase 3, placebo-controlled trial of mirabegron that included tolterodine as an active comparator (SCORPIO), as well as other published literature and expert opinion. Cost-effectiveness was calculated from Canadian public payer (based on Quebec list prices) and societal perspectives. Results: The incremental one-year cost per patient for mirabegron over tolterodine was $182 CAD and $157 CAD from the payer and societal perspectives, respectively. The incremental quality-adjusted life year (QALY) gain for mirabegron was 0.0066 when using EQ-5D health-state utilities. Mirabegron was cost-effective compared with tolterodine, from both payer and societal perspectives, and remained cost-effective vs. tolterodine across the majority of sensitivity analyses. The model was based on limited clinical trial evidence supplemented with expert opinion and assumptions; a select number of OAB symptoms, AEs, and direct and indirect medical costs associated with OAB; and a timeframe of only one year. Conclusions: From the payer and societal perspectives, the health economic model indicates that in Canada, mirabegron is a cost-effective treatment strategy compared with tolterodine, leading to improved health outcomes (QALYs) at an acceptable incremental cost. IntroductionOveractive bladder (OAB) is a bothersome condition with a relatively high prevalence in the general population. In a survey of over 16 500 subjects aged ≥40 years in six European countries, the prevalence of OAB was 16.6%.1 In a subsequent survey of over 19 000 subjects aged ≥18 years in Canada and Europe, the prevalence of OAB was 11.8%. OAB has a substantial negative impact on patients' health-related quality of life (HRQoL) and mental health. 5The cardinal symptoms -urgency with or without incontinence, usually associated with frequency, and nocturia 6 -interfere with basic activities of daily living, such as work, travel, sleep, interpersonal activities, sexual function, and physical activities. 7,8 Studies have often focused specifically on the impact of incontinence, but it has been shown that frequency and urgency, which are more prevalent, are as bothersome as urgency incontinence.1 In terms of mental health, it is estimated that approximately one-third of men and women with lower urinary tract symptoms may have comorbid clinical anxiety and/or depression. 9 In addition, it has been shown that the prevale...

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Costs Associated with the Management of Overactive Bladder and Related Comorbidities

Cited by 88 publications

References 24 publications

Comparing Adherence and Persistence Across 6 Chronic Medication Classes

Comparing Adherence and Persistence Across 6 Chronic Medication Classes

Social, economic, and health utility considerations in the treatment of overactive bladder

Cost-effectiveness of mirabegron compared to tolterodine ER 4 mg for overactive bladder in Canada

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