Cost-effectiveness analysis of newer anticholinergic drugs for urinary incontinence vs oxybutynin and no treatment using data on persistence from the Swedish prescribed drug registry

• OBJECTIVE To analyse the cost-effectiveness of newer anticholinergic drugs in relation to oxybutynin immediate release (IR) and no treatment for patients with urgency urinary incontinence. PATIENTS AND METHODS A decision analytic model was constructed. Results were collected from randomized trials and combined with registry data on persistence of medicine use and estimated number of severe adverse events. The setting corresponds to Swedish clinical practice. The costs and effects of the treatment options were analysed over a period of 1 year. Costs included drug costs, treatment costs and costs for pad use. Patients' utilities were based on treatment effect and the lack or presence of adverse events. RESULTS No treatment was the least costly treatment but also resulted in the fewest number of quality adjusted life years (QALYs). Treatment with newer anticholinergic drug medications is the most costly option but also the most efficient treatment. Sensitivity analyses showed that the results were robust. Treatment with newer anticholinergics resulted in a cost per QALY gained of (sic)21 045 compared with no treatment and no effect and (sic)65 435 compared with no treatment and placebo effect. Compared with oxybutynin IR, the cost per QALY gained was (sic)37 119. These calculations are based on relatively low pad costs, resulting in higher costs per QALY for the original drugs. CONCLUSIONS The newer anticholinergic medications are likely to be cost effective in relation to oxybutynin IR. The cost-effectiveness of the newer anticholinergics compared with no treatment depends on assumptions of the effect of no treatment, the severity of the treated condition and the treated individual's risk of adverse events. Treatment is less likely to be cost effective for elderly persons or for persons otherwise at higher risk for adverse events.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Neurosciences (hsv//eng)

Keyword

cost-effectiveness

anticholinergic drugs

urinary incontinence

urgency urinary incontinence

oxybutynin

Publication and Content Type

ref (subject category)

art (subject category)