title: Cost effectiveness of mirabegron compared with tolterodine extended release for the treatment of adults with overactive bladder in the United Kingdom.
abstract: BACKGROUND
  Overactive bladder (OAB) is highly prevalent and is associated with considerable morbidity and reduced health-related quality of life. β3-adrenergic receptor (β3-AR) stimulation is a novel alternative to antimuscarinic therapy for OAB.
  
  
  OBJECTIVE
  The objective of this analysis was to assess the cost effectiveness of the β3-AR agonist mirabegron relative to tolterodine extended release (ER) in patients with OAB from a UK National Health Service (NHS) perspective.
  
  
  METHODS
  A Markov model was developed to simulate the management, course of disease, and effect of complications in OAB patients over a period of 5 years. Transition probabilities for symptom severity levels and probabilities of adverse events were estimated from the results of the randomised, double-blind SCORPIO trial in 1,987 patients with OAB. Other model inputs were derived from the literature and on assumptions based on clinical experience.
  
  
  RESULTS
  Total 5-year costs per patient were £1,645.62 for mirabegron 50 mg/day and £1,607.75 for tolterodine ER 4 mg/day. Mirabegron was associated with a gain of 0.009 quality-adjusted life-years (QALYs) with an additional cost of £37.88. The resulting incremental cost-effectiveness ratio (ICER) was £4,386/QALY gained. In deterministic sensitivity analyses in the general OAB population and several subgroups, ICERs remained below the generally accepted willingness-to-pay (WTP) threshold of £20,000/QALY gained. The probability of mirabegron 50 mg being cost effective relative to tolterodine ER 4 mg was 89.4 % at the same WTP threshold.
  
  
  CONCLUSIONS
  Mirabegron 50 mg/day is likely to be cost effective compared with tolterodine ER 4 mg/day for adult patients with OAB from a UK NHS perspective.
authors.affiliation: Creativ-Ceutical SARL, 215, rue du Faubourg St-Honoré, 75008, Paris, France, sab@creativ-ceutical.com.
authors.forename: Samuel
authors.initials: S
authors.lastname: Aballéa
authors.forename: Khaled
authors.initials: K
authors.lastname: Maman
authors.forename: Katia
authors.initials: K
authors.lastname: Thokagevistk
authors.forename: Jameel
authors.initials: J
authors.lastname: Nazir
authors.forename: Isaac A O
authors.initials: IA
authors.lastname: Odeyemi
authors.forename: Zalmai
authors.initials: Z
authors.lastname: Hakimi
authors.forename: Andy
authors.initials: A
authors.lastname: Garnham
authors.forename: Mondher
authors.initials: M
authors.lastname: Toumi
mesh_terms: D000083:Acetanilides / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D000328:Adult; D001559:Benzhydryl Compounds / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003408:Cresols / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D004311:Double-Blind Method; D006801:Humans; D010665:Phenylpropanolamine / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D011788:Quality of Life; D013844:Thiazoles / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D000068737:Tolterodine Tartrate; D006113:United Kingdom; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000503:physiopathology; D064804:Urological Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use
chemical_list: D000083:Acetanilides; D001559:Benzhydryl Compounds; D003408:Cresols; D013844:Thiazoles; D064804:Urological Agents; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; C520025:mirabegron