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Cost-effectiveness analysis of solifenacin versus oxybutynin immediate-release in the treatment of patients with overactive bladder in the United Kingdom.
- Source :
-
Journal of medical economics [J Med Econ] 2013 Oct; Vol. 16 (10), pp. 1246-54. Date of Electronic Publication: 2013 Sep 11. - Publication Year :
- 2013
-
Abstract
- Objective: To carry out a cost-utility analysis comparing initial treatment with solifenacin 5 mg/day vs oxybutynin immediate-release (IR) 15 mg/day for the treatment of patients with overactive bladder (OAB) from the perspective of the U.K. National Health Service (NHS).<br />Methods: A Markov model with six health states was developed to follow a cohort of OAB patients treated with either solifenacin or oxybutynin during a 1-year period. Costs and utilities were accumulated as patients transited through the health states in the model and a drop-out state. Some of the solifenacin patients were titrated from 5 mg to 10 mg/day at 8 weeks. A proportion of drop-out patients were assumed to continue treatment with tolterodine ER. Utility values were obtained from a Swedish study and pad use was based on a multinational clinical trial. Adherence rates for individual treatments were derived from a U.K. database study. For pad use and utility values, the drop-out state was split between those patients who were no longer receiving treatment and those on second-line therapy. Patients on second-line therapy who drop-out were referred for a specialist visit. Results were expressed in terms of incremental cost-utility ratios.<br />Results: Total annual costs for solifenacin and oxybutynin were £504.30 and £364.19, respectively. First-line drug use represents 49% and 4% of costs and pad use represent 23% and 40% of costs for solifenacin and oxybutynin, respectively. Differences between cumulative utilities were small but were greater for solifenacin (0.7020 vs. 0.6907). The baseline incremental cost-effectiveness ratio was £12,309/QALY.<br />Conclusion: Under the baseline assumptions, solifenacin would appear to be cost-effective with an incremental cost-utility of less than £20,000/QALY. However, small differences in utility between the alternatives and the large number of drop-outs means that the results are sensitive to small adjustments in the values of utilities assigned to the drop-out state.
- Subjects :
- Benzhydryl Compounds administration & dosage
Benzhydryl Compounds adverse effects
Cohort Studies
Cost-Benefit Analysis
Cresols administration & dosage
Cresols adverse effects
Humans
Incontinence Pads economics
Incontinence Pads statistics & numerical data
Mandelic Acids administration & dosage
Mandelic Acids adverse effects
Markov Chains
Medication Adherence statistics & numerical data
Models, Economic
Muscarinic Antagonists administration & dosage
Muscarinic Antagonists adverse effects
Muscarinic Antagonists economics
Patient Dropouts statistics & numerical data
Phenylpropanolamine administration & dosage
Phenylpropanolamine adverse effects
Quality-Adjusted Life Years
Quinuclidines administration & dosage
Quinuclidines adverse effects
Solifenacin Succinate
Tetrahydroisoquinolines administration & dosage
Tetrahydroisoquinolines adverse effects
Tolterodine Tartrate
Treatment Outcome
United Kingdom
Urinary Bladder, Overactive complications
Urinary Incontinence drug therapy
Urinary Incontinence etiology
Benzhydryl Compounds economics
Cresols economics
Mandelic Acids economics
Phenylpropanolamine economics
Quinuclidines economics
Tetrahydroisoquinolines economics
Urinary Bladder, Overactive drug therapy
Urinary Bladder, Overactive economics
Urinary Incontinence economics
Subjects
Details
- Language :
- English
- ISSN :
- 1941-837X
- Volume :
- 16
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of medical economics
- Publication Type :
- Academic Journal
- Accession number :
- 23885660
- Full Text :
- https://doi.org/10.3111/13696998.2013.829079