title: Cost-effectiveness of novel therapies for overactive bladder.
abstract: Overactive bladder is a difficult to treat condition affecting a large proportion of adults resulting in considerable economic impact to society. First-line treatments such as behavioral therapy or antimuscarinic medication are frequently not effective in adequately controlling symptoms or have intolerable side effects. Patients subsequently require second-line therapy including, sacral neuromodulation through either posterior tibial nerve stimulation or sacral nerve stimulation or intra-detrusor injection of Onabotulinumtoxin-A. Mirabegron, a relatively new drug in a separate class, is also employed in the treatment of overactive bladder. The question of which novel therapy to initiate depends on several factors including patient preference, effectiveness and cost. The purpose of this review is to present and discuss the most recent studies pertaining to the cost-effectiveness of novel therapies for overactive bladder.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Female Pelvic Medicine and Reconstructive Surgery, University of Pittsburgh Medical Center, 513 Halket Street, Pittsburgh, PA 15213, USA.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Mayr
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Shepherd
mesh_terms: D000083:Acetanilides / Q000191:economics / Q000627:therapeutic use*; D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004599:Electric Stimulation Therapy / Q000191:economics / Q000379:methods*; D006801:Humans; D018727:Muscarinic Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D013844:Thiazoles / Q000191:economics / Q000627:therapeutic use*; D013979:Tibial Nerve; D053201:Urinary Bladder, Overactive / Q000191:economics / Q000453:epidemiology / Q000628:therapy*
chemical_list: D000083:Acetanilides; D018727:Muscarinic Antagonists; D013844:Thiazoles; D019274:Botulinum Toxins, Type A; C520025:mirabegron
keywords: anticholinergic; antimuscarinic; botox; botulinum neurotoxin A; decision analysis; interstim; mirabegron; posterior tibial nerve stimulation; sacral nerve stimulation; urgency incontinence