Economic Impact of Mirabegron Versus Antimuscarinics for the Treatment of Overactive Bladder in the UK

Our objective was to estimate the economic outcomes of using mirabegron versus antimuscarinics in the treatment of patients with overactive bladder (OAB) from a societal perspective in the UK.

A Markov model was developed using Microsoft Excel®. The time horizon and cycle length are 12 and 1 months, respectively; and the hypothetical cohort size 100 patients. Antimuscarinic comparators are fesoterodine, oxybutynin extended release (ER) and immediate release (IR), solifenacin, tolterodine ER/IR, trospium ER/IR, darifenacin and flavoxate. Model inputs included real-world treatment patterns data, healthcare resource use (e.g. clinic visits) and direct and indirect costs (e.g. drug acquisition and productivity loss). Model outputs included patient disposition, healthcare resource use, drug acquisition costs and other treatment-related costs over a 1-year time horizon. A one-way sensitivity analysis was performed to determine the key drivers of the model.

In a hypothetical cohort of 100 patients, total annual costs per patient were lower with mirabegron than with all antimuscarinics (£1270.84 vs. 1321.71-1607.48). Healthcare resource use was lower with mirabegron than with all antimuscarinics (115 vs. 119-123 general practitioner visits; 173 vs. 178-185 specialist visits and 0.0042 vs. 0.0050-0.0060 surgical operations) and fewer work hours were lost (4017 vs. 5114-6990 [all per 100 patients]). Sensitivity analysis showed the model was sensitive to persistence and switching rates, although the impact on the overall results was minimal.

In the UK, using mirabegron to treat OAB may improve persistence and lead to reductions in switching treatment, healthcare resource utilization, productivity costs, and overall treatment costs versus antimuscarinics.

PharmacoEconomics - open. 2017 Mar [Epub]

Jameel Nazir, Malin Berling, Charles McCrea, Francis Fatoye, Sally Bowditch, Zalmai Hakimi, Adrian Wagg

Astellas Pharma Europe Ltd, Chertsey, KT16 0PS, UK. ., PAREXEL Access Consulting, Stockholm, Sweden., PAREXEL Access Consulting, London, UK., Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK., Astellas Pharma Europe Ltd, Chertsey, KT16 0PS, UK., Astellas Pharma Europe B.V., Leiden, The Netherlands., Geriatric Medicine, University of Alberta, Edmonton, AB, Canada.