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Yearly Trends of Overactive Bladder Medication Usage.
Kevin J Chua1, Hiren V Patel1, Alexandra Tabakin1
1Division of Urology, Department of Surgery, Rutgers, the State University of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Urology Practice
|May 5, 2023
Summary
Oxybutynin remains the most prescribed overactive bladder (OAB) medication, while mirabegron use has significantly increased. Less cognitively impactful anticholinergics are prescribed least often.
Area of Science:
- Urology
- Pharmacology
- Geriatrics
Background:
- Anticholinergic medications for overactive bladder (OAB) are linked to cognitive side effects and dementia.
- Agents like trospium, fesoterodine, and darifenacin show reduced blood-brain barrier penetration.
- Mirabegron, a beta-3 adrenoreceptor agonist, was approved for OAB in 2012.
Purpose of the Study:
- To analyze trends in the prescription patterns of overactive bladder (OAB) medications in the United States.
- To compare the utilization of different OAB drug classes over a five-year period.
Main Methods:
- Utilized the 2013-2017 Medicare Part D Public Use File to identify OAB medication prescribers.
- Analyzed prescription claims and total annual expenditures for oxybutynin, tolterodine, trospium, darifenacin, solifenacin, fesoterodine, and mirabegron.
- Segmented data by all prescribers, non-urologists, and urologists.
Main Results:
- Oxybutynin was the most prescribed OAB medication, accounting for 53.9% of prescriptions in 2017.
- Mirabegron prescriptions surged from 140,401 in 2013 to 1,617,439 in 2017, becoming the second most prescribed.
- Solifenacin prescriptions declined annually, while trospium, darifenacin, and fesoterodine remained the least prescribed.
- Mirabegron incurred the highest total expenditure ($658.6 million in 2017).
Conclusions:
- Oxybutynin consistently led OAB medication prescriptions throughout the study period.
- Mirabegron utilization demonstrated a significant and steady year-over-year increase.
- Anticholinergic drugs with lower cognitive side effect risks were the least utilized OAB treatments.
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