Urinary incontinence: Economic burden and new choices in pharmaceutical treatment

Abstract

In the year 2000, an estimated 17 million community-dwelling adults in the United States had daily urinary incontinence (UI), and an additional 33 million suffered from the overlapping condition, overactive bladder. Estimates of the total annual cost of these conditions range up to 32 billion US dollar; the largest components are management costs and the expenses associated with nursing home admissions attributable to UI. In most cases, patients with UI can be treated with pharmaceutical agents, in addition to behavioral therapy. Until recently, pharmaceutical therapy for UI has been limited, especially because the adverse effects of available agents resulted in poor adherence to treatment regimens. Recent innovations in molecular design and new dosage forms of UI medications offer the promise of fewer and less severe adverse effects and, thus, better treatment outcomes for patients. Additionally, the availability of multiple agents within a therapeutic class offers health care providers a spectrum of choices with which to personalize treatment for each individual patient. New pharmacologic treatment options for UI have the potential to allow greater independence for older persons who reside at home and to delay or avoid the costs of admission to long-term care facilities. Alternate dosage forms, which include patches and sustained-release formulations, may benefit patients who have difficulty chewing, swallowing, or remembering to take medications. Although these newer products are generally more expensive than older forms of therapy, they typically have more favorable cost-effectiveness ratios. Access to these new medications for patients enrolled in public and private health care plans may help to reduce the economic and social burden of UI care.

Incontinence Pad Usage in Medical Welfare Facilities in Korea

“…Consequently, it costs up to 32 billion US dollars annually because of overactive bladder symptoms [7]. A detailed report similar to the investigation from US has not yet been reported in Korea.…”

Modulation of bladder afferent signals in normal and spinal cord‐injured rats by purinergic P2X3 and P2X2/3 receptors

“…More than 10% of the USA population with urinary incontinence have overactive bladder (OAB) symptoms, and <30% continue antimuscarinic therapy, the most common OAB treatment, after 1 year [1]. OAB symptoms can result from conditions, such as damage to neuronal pathways controlling bladder sensation and filling; myogenic pathologies involving increased detrusor excitability; injury to afferent pathways in the urothelium; or a combination of the above [2,3].…”

Stem Cell Therapy for Stress Urinary Incontinence: A Critical Review

“…In the United States 17 million people were estimated to have this condition and the total annual cost of UI and associated conditions was estimated to range up to 32 billion dollars [2]. UI is 2 to 3 times more prevalent in women than in men up to age 80, after which it affects the sexes equally [3].…”