Cost-effectiveness of overactive bladder treatments: from the US payer perspective.

To assess the cost-effectiveness of onabotulinumtoxinA (onabotA), implantable sacral nerve stimulation devices, percutaneous tibial nerve stimulation, anticholinergic medications and mirabegron compared with best supportive care (BSC) for management of refractory overactive bladder (OAB).

A Markov model was developed to compare the cost-effectiveness of treatment options with BSC over a 10-year time horizon. Resource utilization, discontinuation rates and costs were derived from unpublished and published sources. Quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios were reported.

Treatment with onabotA 100U produced the largest gain in QALYs (7.179) and lowest estimated incremental cost-effectiveness ratio ($32,680/QALY) of all assessed treatments compared with BSC.

Compared with BSC, onabotA 100U was the most cost-effective treatment option for patients with refractory OAB.

Journal of comparative effectiveness research. 2018 Dec 04 [Epub]

Brian Murray, Sam H Hessami, Dmitry Gultyaev, Johanna Lister, Roger Dmochowski, Kristin Khalaf Gillard, Sanja Stanisic, Amy Tung, Robert Boer, Steven Kaplan

Capital Region Urological Surgeons, 319 S Manning Blvd # 106, Albany, NY, 12208, USA., Division of Urogynecology and Pelvic Surgery, New York Medical College, 40 Sunshine Cottage Rd, Valhalla, NY, 10595, USA., Analytica LASER, a Certara company, Meeraner Platz 1, 79539, Lörrach, Germany., Department of Urologic Surgery, Vanderbilt University Medical Center North, Nashville, TN, 37232, USA., Xcenda, 4114 Woodlands Parkway, Palm Harbor, FL, 34685, USA., Analytica LASER, a Certara company, Corso di Porta Nuova 34, 20121, Milano, Italy., Allergan plc, 2525 Dupont Drive, Irvine, CA, 92612, USA., Department of Urology, Mount Sinai Hospital, 625 Madison Avenue, New York, NY, 10022, USA.