To assess the costs of treating overactive bladder (OAB) with fesoterodine compared to no OAB pharmacotherapy among vulnerable elderly from the United States (US) payer perspective.
A decision analytic cost model was developed to estimate the 52-week costs of a cohort of vulnerable elderly with OAB initiating treatment with fesoterodine or no OAB pharmacotherapy.
Vulnerable elderly OAB patients were defined as those ≥65 years with self-reported urge urinary incontinence (UUI) symptoms for ≥3 months, 2-15 UUI episodes/day, and at risk of deteriorating health by a score of ≥3 on the Vulnerable Elders Survey (VES)-13. Patients were evaluated for fesoterodine treatment response (defined as no UUI episodes) and persistence at weeks 12, 26, and 52. The model included a hypothetical health plan with 100,000 elderly members. A total of 7,096 vulnerable elderly subjects were identified as the model target population based on the percentage of vulnerable elderly and annual prevalence of OAB among vulnerable elderly. OAB-related costs included fesoterodine drug acquisition costs, health care resource use (HCRU; inpatient hospitalization, outpatient visits, and physician office visits), and OAB-related comorbidities (falls/fractures, urinary tract infections, depression, and nursing home admissions). All costs were inflated to 2013 US$ using the medical care component of the consumer price index (CPI).
When 7,096 vulnerable elderly OAB patients were treated with fesoterodine, US health care payers could save $11,463,981 per year, or $1,616 per patient vs. no OAB pharmacotherapy. Univariate one-way sensitivity analyses supported the robustness of the findings and showed results were most sensitive to changes in fesoterodine efficacy followed by annual costs of inpatient hospitalization.
From a US payer perspective, treating vulnerable elderly OAB patients with fesoterodine was cost-saving compared to no OAB pharmacotherapy.
Journal of medical economics. 2015 Oct 21 [Epub ahead of print]
Lei Qin, Xuemei Luo, Kelly H Zou, Sonya J Snedecor
a a Pharmerit International , Bethesda , MD , USA ;, b b Pfizer Inc , Groton , CT , USA ;, c c Pfizer Inc , New York , NY , USA. , a a Pharmerit International , Bethesda , MD , USA ;