Cost-effectiveness of overactive bladder treatments from a US commercial and payer perspective.

Aim: The cost-effectiveness of treatment options (anticholinergics, β3-adrenoceptor agonists, onabotulinumtoxinA, sacral nerve stimulation and percutaneous tibial stimulation [the latter two including new rechargeable neurostimulators]) for the management of overactive bladder (OAB) were compared with best supportive care (BSC) using a previously published Markov model. Materials & methods: Cost-effectiveness was evaluated over a 15-year time horizon, and sensitivity analyses were performed using 2- and 5-year horizons. Discontinuation rates, resource utilization, and costs were derived from published sources. Results: Using Medicare and commercial costs over a 15-year time period, onabotulinumtoxinA 100U had incremental cost-effectiveness ratios (ICERs) gained of $39,591/quality-adjusted life-year (QALY) and $42,255/QALY, respectively, versus BSC, which were the lowest ICERs of all assessed treatments. The sensitivity analyses at 2- and 5-year horizons also showed onabotulinumtoxinA to be the most cost-effective of all assessed treatments versus BSC. Conclusion: OnabotulinumtoxinA 100U is currently the most cost-effective treatment for OAB.

Journal of comparative effectiveness research. 2023 Jan 19 [Epub ahead of print]

Brian Murray, Jennifer Miles-Thomas, Amy J Park, Victor B Nguyen, Amy Tung, Patrick Gillard, Anjana Lalla, Victor W Nitti, Christopher J Chermansky

Capital Region Urological Surgeons, 319 S Manning Blvd #106, Albany, NY 12208, USA., Eastern Virginia Medical School, 225 Clearfield Ave, Virginia Beach, VA 23462, USA., Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA., Curta, Inc., 4872 Beach Dr SW, Seattle, WA 98116, USA., Allergan, an AbbVie company, 2525 Dupont Drive, Irvine, CA 92612, USA., David Geffen School of Medicine at UCLA, 300 Stein Plaza Driveway, Los Angeles, CA 90095, USA., University of Pittsburgh Medical Center Magee Womens Hospital, 300 Halket St, Suite 2541, Pittsburgh, PA 15213, USA.

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