SUFU 2020: National Patterns of Filled Prescriptions and Third-Line Treatment Utilization for Women with Overactive Bladder

Scottsdale, Arizona ( The authors evaluated national patterns of care for women with overactive bladder in an administrative dataset and identify potential areas for improvement. They performed analysis using the OptumLabs® Data Warehouse, which contains de-identified administrative claims data from a large national U.S. health insurance plan. The study included women, over age 18, with a new OAB diagnosis from 1/1/2007-6/30/2017. We excluded those who had an underlying neurologic etiology, interstitial cystitis/painful bladder syndrome, were pregnant or did not have continuous enrollment for 12 months before and after OAB diagnosis.

Of 1.4 million women in the database during the study timeframe, 60246 (4%) were included in the study. The median age was 61 years (IQR 50-73), and the median follow-up was 2.6 years (IQR 1.6-4.2). Overall, 37% were treated with anticholinergics, 5% beta-3 agonists, 7% topical estrogen, 2% pelvic floor physical therapy, 26% saw a specialist, and 2% underwent third-line therapy. The median time to cessation of prescription filling was longer for beta-3 agonists versus anticholinergics (median 4.1 months [IQR 1-15] vs 3.6 months [IQR 1-10]; p <0.0001). The use of third-line therapies significantly increased over the study timeframe, from 1.1% to 2.2%(p<0.0001). 

The authors found that the majority of patients do not continue filling prescriptions for OAB medications, and a minority of patients were referred for specialty evaluation. While third-line therapy use is increasing, it is used in a small proportion of women with OAB. Given these patterns, there may be an underutilization of specialist referral and other OAB therapies. 

Presented by: Nicole A Dodge, MD, Department of Urology, Mayo Clinic Rochester, Minnesota

Co-Authors: Elizabeth B Habermann,2 John B Gebhart,3 Daniel S Elliott,1 Holly K Van Houten,2 Lindsey R Sangaralingham,2 Brian J Linder1
1Mayo Clinic Rochester Department of Urology,2Mayo Clinic Rochester Health Services Research,3Mayo Clinic Rochester Department of OB/GYN

Written by: Bilal Farhan, MD, Assistant Professor, Division of Urology, University of Texas, Medical Branch, Texas; @BilalfarhanMD, at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting, SUFU 2020, February 25 - February 29, 2020, Scottsdale, Arizona