Abstract
BackgroundOveractive bladder (OAB) is associated with high healthcare costs, which may be partially driven by drug treatment. There is little comparative data on antimuscarinic drugs with respect to resource use and costs. This study was conducted to address this gap and the growing need for naturalistic studies comparing health economics outcomes in adult patients with OAB syndrome initiating treatment with different antimuscarinic drugs in a primary care setting in Spain.MethodsMedical records from the databases of primary healthcare centres in three locations in Spain were assessed retrospectively. Men and women ≥18 years of age who initiated treatment with fesoterodine, tolterodine or solifenacin for OAB between 2008 and 2010 were followed for 52 weeks. Healthcare resource utilization and related costs in the Spanish National Health System were compared. Comparisons among drugs were made using multivariate general linear models adjusted for location, age, sex, time since diagnosis, Charlson comorbidity index, and medication possession ratio.ResultsA total of 1,971 medical records of patients (58.3% women; mean age, 70.1 [SD:10.6] years) initiating treatment with fesoterodine (n = 302), solifenacin (n = 952) or tolterodine (n = 717) were examined. Annual mean cost per patient was €1798 (95% CI: €1745; €1848). Adjusted mean (95% bootstrap CI) healthcare costs were significantly lower in patients receiving fesoterodine (€1639 [1542; 1725]) compared with solifenacin (€1780 [€1699; €1854], P = 0.022) or tolterodine (€1893 [€1815; €1969], P = 0.001). Cost differences occurred because of significantly fewer medical visits, and less use of absorbent products and OAB-related concomitant medication in the fesoterodine group.ConclusionsCompared with solifenacin and tolterodine, fesoterodine was a cost-saving therapy for treatment of OAB in the primary care setting in Spain.
Highlights
Overactive bladder (OAB) is associated with high healthcare costs, which may be partially driven by drug treatment
The main objectives of the study were to compare healthcare resource utilization related to the clinical management of OAB syndrome and corresponding costs in patients treated with fesoterodine, tolterodine, or solifenacin for the first time in the primary care setting in Spain’s National Health System (NHS)
Of the 170,880 patients regularly seen at the study sites, 2778 patients initiated OAB treatment during the study period
Summary
Overactive bladder (OAB) is associated with high healthcare costs, which may be partially driven by drug treatment. This study was conducted to address this gap and the growing need for naturalistic studies comparing health economics outcomes in adult patients with OAB syndrome initiating treatment with different antimuscarinic drugs in a primary care setting in Spain. Overactive bladder (OAB) is a syndrome characterized by symptoms of urinary urgency, with or without urge incontinence, often accompanied by daytime frequency and nocturia. It is caused by an overactive detrusor muscle and may be accompanied by neurological dysfunction [1,2,3]. In Spain the population-based EPICC study estimated the prevalence of OAB to be 21.5% in adults ≥40 years of age and 38.5% in institutionalized people ≥65 years of age [9,10]. Many individuals do not seek professional help for OAB symptoms and only a quarter receive treatment [5,16,17]
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