Cost Effectiveness of Fesoterodine and Tolterodine for the Treatment of Overactive Bladder with Urge Urinary Incontinence in Spain and Finland

Abstract

Fesoterodine is cost effective or cost saving relative to tolterodine ER for the treatment of OAB with UUI in two European countries. Payers and prescribers should consider a broad scope of costs to make informed cost-conscious choices of antimuscarinic treatment.

No Increased Risk of Fracture in Patients Receiving Antimuscarinics for Overactive Bladder Syndrome: A Retrospective Cohort Study

“…1,2 This disease affects more than 34 million individuals in the United States, and those patients with OAB usually experience a low quality of life and various diseases, including fractures, urinary tract infections, and depression. [3][4][5][6] Recently, some antimuscarinics, such as oxybutynin, tolterodine, and trospium, were recognized as firstline pharmacological management for OAB. 7 These antimuscarinics can selectively block muscarinic receptors located on the bladder detrusor muscle, depress abnormal contractions of the bladder, and improve symptoms of OAB.…”

“…Overactive bladder (OAB) syndrome is a common disease that is characterized by the clinical symptoms of urinary frequency, urinary urgency, and nocturia, with or without urinary incontinence . This disease affects more than 34 million individuals in the United States, and those patients with OAB usually experience a low quality of life and various diseases, including fractures, urinary tract infections, and depression . Recently, some antimuscarinics, such as oxybutynin, tolterodine, and trospium, were recognized as first‐line pharmacological management for OAB .…”

Cost-effectiveness analysis of fesoterodine flexible dose in newly diagnosed patients with overactive bladder in routine clinical practice in Spain

“…In different economic evaluations with fesoterodine published in Spain, where a CEA has been performed, the superiority of fesoterodine has been shown, compared with other drugs for the symptomatic treatment of OAB. 17 – 19 These economic evaluations have shown that, compared with solifenacin, tolterodine or mirabegron, fesoterodine has an ICER under the cost-effectiveness threshold normally accepted in Spain for inclusion in the pharmaceutical services of NHS. 25 The economic superiority of fesoterodine compared with other antimuscarinic drugs available in our health care setting has also been shown in conditions of routine or real-life practice, indicating that fesoterodine can lead to health care savings in the treatment of OAB, which is NHS-funded, and offsetting its higher pharmacological cost with less use of health care resources, such as medical visits, absorbents, or concomitant medication related to OAB (antidepressants, anxiolytics, etc), in patients of any age and in vulnerable subjects.…”

“…However, this might not be a significant problem from an economic point of view, as has been observed in other economic evaluations carried out in our health care setting with antimuscarinic drugs. 17 – 19 Finally, this evaluation was not performed from the society’s perspective, because this study did not take into account variables such as payment for absorbents by the patient, travel costs, losses in productivity, or their impact on indirect costs.…”

“…Given the limited health care resources of the National Health Service (NHS), economic evaluations of cost-effectiveness provide evidence for deciding on the most appropriate use of resources. To date, economic evaluations with antimuscarinic drugs have not addressed the cost-effectiveness of flexible doses, 17 – 19 despite this being a routine practice in the treatment of these patients in real life. 16 Therefore, the purpose of this study is to conduct a cost-effectiveness analysis (CEA) from the perspective of Spain’s NHS.…”