Cost-effectiveness analysis of fesoterodine flexible dose in newly diagnosed patients with overactive bladder in routine clinical practice in Spain

• Published in: ClinicoEconomics and outcomes research 2016-01, Vol.8, p.541-550
• Main Authors: Peral, Carmen, Sánchez-Ballester, Francisco, García-Mediero, José M, Ramos, Jaime, Rejas, Javier
• Format: Article
• Language: English
• Subjects: Activities of daily living; Antimuscarinic; Bladder; Clinical medicine; Cost analysis; Cost benefit analysis; Drug dosages; Economic aspects; Fesoterodine; Flexible-dose; Gynecology; Health care costs; Hospitals; Medical care quality; Medical care utilization; Original Research; Overactive bladder; Patient compliance; Patients; Primary care; Quality of life; Questionnaires; Task forces; Urinary incontinence; Urogenital system; Urology
• ISSN: 1178-6981; 1178-6981
• DOI: 10.2147/CEOR.S111646

To carry out cost-effectiveness analysis from the Spanish National Health System perspective, of treating overactive bladder (OAB), in newly diagnosed patients with two flexible doses of fesoterodine in routine clinical practice. Economic evaluation of flexible-dose fesoterodine in newly diagnosed patients, including two treatment groups: standard escalating from 4 to 8 mg or fast escalating to 8 mg. Costs were estimated from health care resources utilization related to OAB, and were expressed in 2015 Euros. Quality-adjusted life-years (QALYs) were obtained from overactive bladder questionnaire-short form. Univariate and probabilistic sensitivity analyses were carried out. Three hundred and ninety symptomatic OAB patients treated with fesoterodine and newly diagnosed (141 in fast escalating group and 249 in standard escalating) were analyzed. Adjusted health care total costs were not statistically different; difference -€4.1 (confidence interval: -153.3; 25.1) =0.842. QALYs were higher in fast escalating to high dose vs standard escalating group, resulting in a cost of -€16,020/QALY gained for fast escalating vs standard escalating group. When the cost-effectiveness threshold is set at a maximum value of €30,000/QALY gained, fesoterodine fast escalating group was cost-effective vs standard escalating group 67.6% of the time. The treatment with fesoterodine, in female patients newly diagnosed, fast escalating to 8 mg was a cost-effective option relative to escalating traditionally from 4 to 8 mg, in the management of OAB in routine clinical practice, from the Spanish National Health System perspective.