Inequities in Filled Overactive Bladder Medication Prescriptions in the US

Area of Science:

• Pharmacology
• Health Services Research
• Health Equity

Background:

• Anticholinergic medications for overactive bladder (OAB) are linked to cognitive decline risks.
• Beta-3 adrenoceptor agonists (β3-agonists) offer comparable efficacy for OAB without the cognitive risks.
• Anticholinergics remain the most prescribed OAB medications in the US despite these concerns.

Purpose of the Study:

• To investigate if patient race, ethnicity, and sociodemographic factors influence the prescription of anticholinergic versus β3-agonist medications for OAB.
• To identify potential disparities in OAB medication prescribing patterns.

Main Methods:

• Cross-sectional analysis of the 2019 Medical Expenditure Panel Survey, a representative sample of US households.
• Inclusion criteria: individuals with a filled prescription for OAB medication.
• Data analysis conducted from March to August 2022, focusing on medication receipt and patient characteristics.

Main Results:

• In 2019, 2,971,449 individuals filled OAB prescriptions; 75.0% received anticholinergics and 19.9% received β3-agonists.
• Non-Hispanic Black individuals were 54% less likely to fill a β3-agonist prescription compared to non-Hispanic White individuals, after adjusting for covariates.
• Non-Hispanic Black women showed an even lower likelihood (80% less likely) of receiving a β3-agonist prescription.

Conclusions:

• Significant disparities exist in the prescription of OAB medications, with non-Hispanic Black individuals less likely to receive β3-agonists.
• These prescribing differences suggest potential inequities that may exacerbate healthcare disparities.
• Further research is needed to explore individual and societal factors contributing to these observed disparities in OAB treatment.