PUK5 OVERACTIVE BLADDER IN THE UNITED STATES LONG-TERM CARE SETTING IS ASSOCIATED WITH SIGNIFICANT BURDEN AND INCREASED HEALTHCARE RESOURCE UTILIZATION AND COSTS: A RETROSPECTIVE DATABASE STUDY

Abstract

An estimated 30 million Americans are affected by bothersome symptoms of overactive bladder (OAB). Approximately 70% of long-term care (LTC) patients suffer from urinary incontinence. We evaluated one-year, all-cause healthcare resource utilization (HCRU) and costs among patients with or without OAB. A retrospective cohort analysis was conducted using claims from IQVIA’s LTC data linked to IQVIA’s integrated data warehouse. Adult patients with ≥2 OAB/urinary incontinence medication prescriptions in LTC were propensity score matched to patients without an OAB medication in LTC between May 2013 and May 2018. Differences in baseline demographic and clinical characteristics used for propensity score matching were examined using standardized differences. HCRU and costs measured during the pre- and post-index periods were compared between OAB and non-OAB cohorts. Adjusted cost-ratio for OAB vs non-OAB cohort was estimated using generalized estimating equation model. Post matching, OAB and non-OAB cohorts had 159,785 patients; mean age 75 years. A statistically significant (p<0.05) higher proportion of patients in OAB (vs non-OAB) cohort were females (74.0% vs 66.8%), had baseline prescriptions for medications metabolized by CYP2D6 (73.8% vs 67.3%) and antidepressants (54.3% vs 45.7%), had follow-up physician office visits (71.3% vs 65.3%) and outpatient visits related to OAB/incontinence (26.2% vs 6.4%), had urinary catheterizations (58.8% vs 39.6%) and falls/fractures (30.5% vs 25.5%). Patients with OAB were prescribed a median of 9 medications/month and 84.0% of patients were exposed to a non-urinary anticholinergic. Mean total all-cause healthcare and pharmacy costs were significantly higher ($15,870 vs $12,975 and $8,271 vs $5,676; standardized differences >0.1) for OAB vs non-OAB cohort. Adjusted analyses demonstrated 17% higher total costs in OAB vs non-OAB cohort (cost ratio: 1.17, 95% CI: 1.15-1.18; p<0.0001). OAB is associated with significant disease and economic burden in the US LTC setting, indicating a need for better treatment management.