Economic impact of using fesoterodine for the treatment of overactive bladder with urge urinary incontinence in a vulnerable elderly population in the United States

Figures & data

Figure 1. Decision analytic model design diagram.

Table 1. Model inputs.

	Base-case value^a
Treatment efficacy, %
Fesoterodine responders at week 128	50.8
Remission over 2 years among  untreated patients^b20	2.0
Patients remaining on treatment  at weeks 12, 26, and 5221	92.4, 58.6, 37.1
Model costs,^c $
Fesoterodine, per day22	7.27
Inpatient hospitalization13
Responder	4576
Non-responder	6228
Outpatient hospitalization13
Responder	1321
Non-responder	2406
Physician office visits13
Responder/Remission	2991
Non-responder13^,23	7333
Non-remission	5518
Falls/fracture, per event30	13,563
UTI, per event31	1225
Depression, per event32	19,915
Nursing facilities, per 12 weeks25	9878

^aUnivariate sensitivity analysis varied model inputs by ±25% unless otherwise specified.

^bAlternative values analyzed within scenario analyses were: 0%, 10.3%, and 36%.

^cCosts presented in 2013 US dollars.

Table 2. OAB-related comorbidities.

OAB-related comorbidities	Treatment responders		Treatment non-responders		No treatment, OAB remission2		No treatment, without OAB remission3
	Annual probability	No. per patient	Annual probability	No. per patient	Annual probability	No. per patient	Annual probability	No. per patient
Falls/fracture11	42.3%	–	55.4%	–	42.3%	–	55.4%	–
Urinary tract infection11^,24	16.3%	1.58	45.7%	2.28	16.3%	1.58	45.7%	2.28
Depression11	11.7%	–	23.9%	–	11.7%	–	23.9%	–
Nursing home33	2.9%	–	7.5%	–	2.9%	–	7.5%	–

Table 3. Estimated yearly medical costs in vulnerable elderly OAB patients (n = 7096) in 2013 US$.

Cost component	Fesoterodine	No treatment	Cost difference
Total anti-muscarinic drug, $	7,832,919	0	7,832,919
Total HCRU, $	92,889,606	100,162,050	−7,272,445
Inpatient hospitalization	41,407,439	44,111,891	−2,704,452
Outpatient visits	15,242,498	17,019,337	−1,776,839
Physician office visits	36,239,668	39,030,822	−2,791,154
Total OAB-related comorbidities, $	107,660,868	119,685,323	−12,024,455
Falls/fracture	62,308,176	66,983,236	−4,675,059
Urinary Tract Infection	8,759,786	10,763,598	−2,003,812
Depression	31,982,765	36,551,387	−4,568,622
Nursing Homes	4,610,141	5,387,103	−776,962
Total medical costs, $	208,383,392	219,847,373	−11,463,981
Total medical cost per patient, $	29,367	30,982	−1616

HCRU, healthcare resource use; OAB, overactive bladder.

Figure 2. Univariate sensitivity analysis on varying input parameters by ±25% centered on the base case estimates. Vertical dotted lines represent ±25% change from the base case result.

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