1. Health economics perspective of fesoterodine, tolterodine or solifenacin as first-time therapy for overactive bladder syndrome in the primary care setting in Spain
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A. Ruiz-Torrejón, Jordi Ibáñez-Nolla, Marion Kvasz, Ruth Navarro-Artieda, Antoni Sicras-Mainar, Alba Aguado-Jodar, and Javier Rejas
- Subjects
Male ,Quinuclidines ,compuestos de bencidrilo ,Cost-Benefit Analysis ,Phenylpropanolamine ,humanos ,síndrome ,Cholinergic Agents ,costos de la atención de salud ,colinérgicos ,Cresols ,Antimuscarinics ,Tetrahydroisoquinolines ,Health care ,Prevalence ,anciano ,Medical record ,resultado del tratamiento ,prevalencia ,General Medicine ,Solifenacin Succinate ,Syndrome ,Health Care Costs ,fármacos urológicos ,Treatment Outcome ,Overactive bladder ,Urological Agents ,Female ,Tolterodine ,medicine.drug ,Research Article ,medicine.medical_specialty ,quinuclidinas ,Tolterodine Tartrate ,Urology ,Urinary Bladder ,stomatognathic system ,fenilpropanolamina ,Internal medicine ,vejiga urinaria ,medicine ,Fesoterodine ,Humans ,Benzhydryl Compounds ,cresoles ,Aged ,Retrospective Studies ,Health economics ,Solifenacin ,Primary Health Care ,business.industry ,Urinary Bladder, Overactive ,estudios retrospectivos ,Retrospective cohort study ,Health resources ,medicine.disease ,Costs ,Primary care setting ,Reproductive Medicine ,Spain ,business ,tetrahidroisoquinolinas - Abstract
Background: Overactive bladder (OAB) is associated with high healthcare costs, which may be partially driven by drug treatment. There is little comparative data on antimuscarinic drugs with respect to resource use and costs. This study was conducted to address this gap and the growing need for naturalistic studies comparing health economics outcomes in adult patients with OAB syndrome initiating treatment with different antimuscarinic drugs in a primary care setting in Spain. Methods: Medical records from the databases of primary healthcare centres in three locations in Spain were assessed retrospectively. Men and women >= 18 years of age who initiated treatment with fesoterodine, tolterodine or solifenacin for OAB between 2008 and 2010 were followed for 52 weeks. Healthcare resource utilization and related costs in the Spanish National Health System were compared. Comparisons among drugs were made using multivariate general linear models adjusted for location, age, sex, time since diagnosis, Charlson comorbidity index, and medication possession ratio. Results: A total of 1,971 medical records of patients (58.3% women; mean age, 70.1 [SD: 10.6] years) initiating treatment with fesoterodine (n = 302), solifenacin (n = 952) or tolterodine (n = 717) were examined. Annual mean cost per patient was (sic)1798 (95% CI: (sic)1745; (sic)1848). Adjusted mean (95% bootstrap CI) healthcare costs were significantly lower in patients receiving fesoterodine ((sic)1639 [1542; 1725]) compared with solifenacin ((sic)1780 [(sic)1699; (sic)1854], P = 0.022) or tolterodine ((sic)1893 [(sic)1815; (sic)1969], P = 0.001). Cost differences occurred because of significantly fewer medical visits, and less use of absorbent products and OAB-related concomitant medication in the fesoterodine group. Conclusions: Compared with solifenacin and tolterodine, fesoterodine was a cost-saving therapy for treatment of OAB in the primary care setting in Spain., This study was sponsored by Pfizer Inc. Javier Rejas and Marion Kvasz are employees of Pfizer, S.L.U. and Pfizer PIO, respectively. Antoni Sicras was a paid consultant to Pfizer in connection with the development of this manuscript. Statistical analysis was performed by DataClinics and was funded by Pfizer Inc. All other authors declare that they have no competing interests. Editorial support was provided by Colin Mitchell, PhD, of Complete Healthcare Communications, Inc., and was funded by Pfizer Inc.
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