Analysis of costs and consequences related to the persistence of Mirabegron and antimuscarinic treatments and their impact on quality of life in patients with overactive bladder in Spain: Results of a probabilistic model

Autors de IIS La Fe

• Salvador Arlandis Guzmán

  Autor

Autors aliens a IIS La Fe

• Cidre, NAJ
• Rubio-Rodriguez, D
• Rubio-Terres, C
• Landeira, M
• Blanco, N

Grups d'Investigació

• Urología

  Leader

  Francisco Boronat Tormo

Abstract

OBJECTIVE: To evaluate whether the lower dropout rote of the treatment of overactive bladder (OAB) with mirabegron could generate cost savings to the National Health System (NHS) and lead to quality-adjusted life years (QALYs) gains, compared to the most commonly prescribed antimuscarinics (AM) in Spain (tolterodine, fesoterodine, oxybutynin, solifenacin). METHODS: A probabilistic model (second order Monte Carlo simulation) in a hypothetical cohort of 1,000 patients with OAB and a time horizon of 1 year was carried out. Discontinuation and persistence rates for both mirabegron and AM were obtained from a Spanish observational study in 1798 patients. Unit costs ((sic) 2018) and utility loss associated with treatment discontinuation were obtained from Spanish public prices and literature, respectively. RESULTS: Persistence rates in patients treated with mirabegron were twice as high compared to AM, leading to a QALY gain of 0.0151 +/- 0.0007 per year. Treatment with mirabegron could generate savings of 80.74 +/- 4.61 (sic) per patient per year compared to AM, assuming 100% probability of saving. The hypothetical substitution of AM treatment for mirabegron could potentially generate savings of 6.6 million euros (95% CI 3.9-10.1 million euros) to the NHS and 1,238 QALYs gains (095% 731; 1,885 QALYs) within a period of 1 year. CONCLUSIONS: The probabilistic model presented showed a greater persistence in patients treated with mirabegron compared to AM, leading to o positive impact in patients quality of life, as well cost savings to the NHS in Spain.

Keywords

• Mirabegron; Antimuscarinics; Overactive bladder; Persistence; Costs and consequences