Economic impact of using fesoterodine for the treatment of overactive bladder with urge urinary incontinence in vulnerable elderly population in the United States

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 ;