To better understand prescribing patterns of several anticholinergic and beta-3 agonist medications used in treatment of overactive bladder (OAB) through analysis of a large national provider database.
We conducted a retrospective review of 2013-2023 Medicare Part D claims data in conjunction with CMS-published data on Medicare-enrolled provider characteristics. Primary outcomes included whether there was a significant difference in the spread of provider characteristics within each medication- or class-specific subset compared to the overall cohort. Univariate analysis was conducted using one-sample proportion testing.
257,929 unique providers prescribed medications for OAB between 2013 and 2023. Most prescribers were located in major metropolitan areas and urologists consistently comprised roughly 7% of the overall cohort. The number of advanced practice providers (APPs) increased nearly 190% over the study period. More Urologists and OBGYNs utilized beta-3 agonists, particularly in the first three years after a drug's FDA approval. Beta-3 agonist use was highest among urban prescribers (p < 0.01), with early adoption of Mirabegron and Vibegron showing particularly pronounced urban predominance.
Uptake of newer medications remains limited, particularly among non-specialists and in non-urban areas. These findings suggest that while newer drugs show distinct prescribing patterns, older medications remain widely prescribed due to broader adoption across specialties and practice settings.
Urology. 2025 Oct 08 [Epub ahead of print]
Grace Khaner, Gregory Vurture, Niharika Malviya, Whitney Clearwater, Melissa Laudano
Albert Einstein College of Medicine. Electronic address: ., Division of Urogynecology, Department of Urology, Albert Einstein College of Medicine - Montefiore Medical Center, Bronx, NY., Department of Urology, Harvard Medical School - Beth Israel Deaconess Medical Center, Boston MA.