Solifenacin in the treatment of overactive bladder syndrome in Italian patients: pharmacoeconomic evaluation

Abstract

Objective: To investigate the pharmacoeconomic performance of treatment with solifenacin, a new antimuscarinic with selectivity for the bladder, when compared to tolterodine and placebo, in Italian patients with overactive bladder (OAB).

Methods: The evaluation was performed using a Markov model. The time horizon of the simulation was 52 weeks, with 1-week cycles. The model simulated outcomes and costs of the treatment with solifenacin (5 mg/day), tolterodine ER (4 mg/day) and no treatment in a cohort representative of the Italian population with OAB. The analysis was conducted mainly from the perspective of the patient, since drugs for the treatment of OAB are not included in the Italian reimbursement list. A supplementary scenario explored the consequences of a hypothetical reimbursement decision by the Italian Health Service to reimburse half of the current retail price in incontinent and responding OAB patients only.

Results: Both treatments produced a reduction in symptoms and improvement in patients' quality of life, with an cost increase of about €540–640/patient/year with solifenacin and €680–780/patient/year with tolterodine. In a cost/utility analysis, solifenacin dominated tolterodine as it resulted in both more effective and less costly treatment; the cost/utility ratio with respect to no treatment was in the range €7,600–18,600/Quality-adjusted life year. The overall expenditure of the hypothesised reimbursement decision was estimated to be about 23 million euros, with a cost/utility ratio of about €600–2,400/Quality-adjusted life year, indicating an efficient allocation of health resources.

Conclusions: While both tolterodine and solifenacin appear to be cost/effective in Italy, the latter has proven to be superior.

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Acknowledgement

Declaration on interest: This study was funded by an unrestricted research grant from Astellas Pharma s.r.l.

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