OAB: which treatment is most cost-effective?

  • Murray B & al.
  • J Comp Eff Res
  • 4 Dec 2018

  • curated by Craig Hicks
  • Clinical Essentials
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Takeaway

  • The most cost-effective treatment option for refractory overactive bladder (OAB) is onabotulinumtoxinA (onabotA; Botox).

Why this matters

  • Because of high health and economic burdens with OAB, cost-effectiveness is an important factor in treatment decisions, say the authors. 

Study design

  • Researchers developed a Markov model to compare the cost-effectiveness of treatment options with best supportive care over the course of 10 years.
  • Treatments in addition to onabotA included implantable sacral nerve stimulation devices, percutaneous tibial nerve stimulation (PTNS), anticholinergic medications, and mirabegron (Myrbetriq).
  • Funding: Allergan plc.

Key results

  • Treatment with 100 U onabotA resulted in the most additional quality-adjusted life-years (QALYs; 7.179) and lowest estimated incremental cost-effectiveness ratio ($32,680/QALY).
  • The next lowest cost-effectiveness ratio was for PTNS ($71,126/QALY).
  • All other treatments yielded a cost-effectiveness ratio >$100,000/QALY.

Limitations

  • The analysis was based on costs in the United States.

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