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

• Published in: Journal of comparative effectiveness research 2023-02, Vol.12 (2), p.e220089-e220089
• Main Authors: Murray, Brian, Miles-Thomas, Jennifer, Park, Amy J, Nguyen, Victor B, Tung, Amy, Gillard, Patrick, Lalla, Anjana, Nitti, Victor W, Chermansky, Christopher J
• Format: Article
• Language: English
• Subjects: Aged; anticholinergic; Botulinum Toxins, Type A - therapeutic use; Cholinergic Antagonists; Cost-Benefit Analysis; cost–effectiveness; Humans; Markov model; Medicare; onabotulinumtoxinA; overactive bladder; Quality-Adjusted Life Years; quality-adjusted life-year; rechargeable sacral nerve stimulation; United States; Urinary Bladder, Overactive - drug therapy; β3-adrenoceptor agonist
• ISSN: 2042-6305; 2042-6313
• DOI: 10.2217/cer-2022-0089

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. 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. 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. OnabotulinumtoxinA 100U is currently the most cost-effective treatment for OAB.