title: A pharmacoeconomic evaluation of two new products for the treatment of overactive bladder.
abstract: The objective of this study is to evaluate the cost effectiveness of two new treatments for overactive bladder: once-daily controlled-release oxybutynin, and twice-daily tolterodine, with a comparison with oxybutynin immediate release. Also estimated are the potential cost savings to a health plan budget resulting from increased utilization of the most cost-effective treatment. The design is a decision-tree model based on clinical trial data and expert panel estimates with a six-month time horizon conducted from a payer perspective. The primary outcome measure used in the analysis was treatment success, with success defined as zero incontinence episodes per week. A secondary outcome measure was the expected number of continent days. As first-line therapy, controlled-release oxybutynin is the most cost-effective treatment as measured by expected cost per success and expected cost per continent days. Controlled-release, once-daily oxybutynin yielded the highest expected success rate and the highest number of expected continent days. The expected cost of treatment with controlled-release oxybutynin was lower than tolterodine and equivalent to immediate-release oxybutynin. Increased utilization of controlled-release oxybutynin results in an estimated saving of $0.007 to $0.026 per member per month for a hypothetical HMO. The model was robust, incorporating all assumptions based on univariate and multivariate sensitivity analysis. Initiating treatment with controlled-release oxybutynin is the most cost-effective approach to treatment for overactive bladder.
authors.forename: S R
authors.initials: SR
authors.lastname: Arikian
authors.forename: J
authors.initials: J
authors.lastname: Casciano
authors.forename: J J
authors.initials: JJ
authors.lastname: Doyle
authors.forename: J E
authors.initials: JE
authors.lastname: Tarride
authors.forename: R N
authors.initials: RN
authors.lastname: Casciano
mesh_terms: D001559:Benzhydryl Compounds / Q000008:administration & dosage / Q000191:economics*; D002017:Budgets; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000191:economics*; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003408:Cresols / Q000008:administration & dosage / Q000191:economics*; D016527:Drug Costs / Q000706:statistics & numerical data*; D006801:Humans; D008333:Mandelic Acids / Q000008:administration & dosage / Q000191:economics*; D010349:Patient Compliance; D010665:Phenylpropanolamine; D016032:Randomized Controlled Trials as Topic; D000068737:Tolterodine Tartrate; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000188:drug therapy* / Q000191:economics
chemical_list: D001559:Benzhydryl Compounds; D018680:Cholinergic Antagonists; D003408:Cresols; D008333:Mandelic Acids; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; C005419:oxybutynin