title: Direct and indirect cost of urge urinary incontinence with and without pharmacotherapy.
abstract: OBJECTIVE
  To evaluate the impact of treating urge urinary incontinence (UUI), including mixed urinary incontinence (MUI), on healthcare resource utilisation, productivity, activity impairment and associated costs.
  
  
  METHODS
  The study used data from the 2011 U.S. National Health and Wellness Survey, an Internet-based questionnaire of a nationwide sample of adults. UUI or MUI respondents were identified via three Incontinence Questions. Respondents with stress urinary incontinence only, prostate cancer or (medication for) benign prostatic hyperplasia were excluded. UUI/MUI respondents were categorised as Rx users for overactive bladder (OAB) and non-Rx users (who never used Rx and whose condition reportedly interfered with life activities or was difficult to manage). Outcome measures included healthcare utilisation and Work Productivity and Activity Impairment questionnaire-based scores. Direct and indirect costs were estimated using 2010 labour and 2008 medical expenditure data sources. Generalised linear models predicted resource use and productivity as a function of treatment status, adjusting for covariates (e.g. sociodemographics, OAB severity, comorbid status) that may also predict impairment.
  
  
  RESULTS
  Rx (vs. non-Rx) users were more likely to be female (80.7% vs. 70.0%), older (mean = 62.7 vs. 53.1) and reporting more moderate-to-severe OAB (70.9% vs. 52.6%; all p < 0.05). Adjusting for covariates, Rx (vs. non-Rx) users had significantly lower activity impairment (41.1% vs. 46.8%), more provider visits (7.42 vs. 5.60) and costs ($18,175 vs. $13,679), and higher total direct costs ($27,291 vs. $21,493), all p < 0.01.
  
  
  CONCLUSIONS
  Urge urinary incontinence patients using, vs. never using, prescription medication reported lower activity impairment but higher direct costs. These findings may inform the degree to which UUI pharmacotherapy affects health outcomes.
authors.affiliation: Kantar Health, New York, NY, USA.
authors.forename: A
authors.initials: A
authors.lastname: Goren
authors.forename: K H
authors.initials: KH
authors.lastname: Zou
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.forename: C
authors.initials: C
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D004526:Efficiency; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000188:drug therapy / Q000191:economics; D055553:Prescription Drugs / Q000627:therapeutic use; D053202:Urinary Incontinence, Urge / Q000178:diet therapy / Q000191:economics*; D064804:Urological Agents / Q000191:economics* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D055553:Prescription Drugs; D064804:Urological Agents