PHS16 - The Economic Burden of Overactive Bladder (OAB) in Brazil: A Retrospective Observational Study Using Data from the Sistema Unico De Saude (SUS)

Abstract

This study aimed to characterize the economic burden among patients with OAB within Brazil’s public healthcare system, SUS. Using data from Brazil’s public health database (DATASUS; covering 70% of Brazil’s population), adults aged ≥18 years with ≥2 ICD-10 diagnostic codes from 2013 to 2015 were included. Percentages and mean annual estimates of OAB-related resource use and costs among OAB patients were calculated using records of outpatient visits, hospitalizations, and procedures, and their associated charges. Patient identifiers were unavailable, requiring a record linkage methodology to match medical encounters to individuals. Pharmacologic management of OAB was informed by government medication purchases available from the Integrated Administration System of General Services and the Health Prices Bank databases. The numbers of OAB patients identified were 25,587 in 2013, 26,282 in 2014, and 26,640 in 2015; or approximately 0.03% of the SUS population. Each year, the percentage of OAB patients who: were hospitalized was 57.8%, 59.2%, and 57.6%; visited a general practitioner (GP) was 9.2%, 11.2%, and 10.0%; and visited a specialist was 38.6%, 40.9%, and 41.3%. Mean OAB-related healthcare costs were R$528, R$567, R$572, per hospitalization; R$20, R$23, R$27, per year for GP visits; and R$28, R$26, R$27, per year for specialist visits, for each respective study year. Regional analysis of government medication purchases suggests access to OAB therapies is highly limited, with oxybutynin representing 99.7% of purchases; sufficient for a year of treatment at 15mg/day for approximately 4,000 patients. Although the number of individuals identified with diagnosed OAB within SUS was markedly low, their healthcare burden was high, as evidenced by a high rate of specialist visits and hospitalizations. Patients with active follow-up for OAB in SUS may represent a more clinically-burdened subpopulation.