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Treatment Patterns in Men Prescribed Benign Prostatic Obstruction or Overactive Bladder Medications in Canada: A
Sarah Neu1, Rano Matta1, Jennifer Locke1
1Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Objective:
To characterize first therapeutic change and healthcare resource utilization in older men initiating an overactive bladder (OAB) or benign prostatic obstruction (BPO) medication.
Methods:
A retrospective cohort study using health administrative data from ICES in Ontario, Canada (from April 01, 2010 to December 31, 2018) was conducted in men aged ≥66 years with ≥1 OAB (β3 agonist, antimuscarinic) or BPO (α-blocker, 5-α-reductase inhibitor) prescription and ≥1-year postindex data (index=first observed dispensation).
Exclusions:
prescriptions for these drugs ≤1 year preindex, a related procedure ≤5 years. Patients were grouped by condition based on index prescription. Treatment changes in relation to OAB and BPO were characterized by type. Costs and healthcare resource utilization pre- and post-index were compared.
Results:
Age, geographic region, and income were similar between groups. The most common initial treatments were antimuscarinics (78.1%) in the OAB group and alpha-blockers (86.4%) in the BPO group. The OAB group was more likely to experience a therapeutic change and had a shorter time to first change in therapy (78 [30,231] vs 104 [30,350] days) and higher mean healthcare costs both pre- ($12,354 vs $11,497) and postindex ($14,423 vs $12,852). The most common first therapeutic change in both groups was discontinuing treatment (OAB: 75.6%; BPO: 69.9%).
Conclusion:
Men initiating OAB medications changed therapy sooner than those initiating BPO medications. Most discontinued first-line therapy without initiating further treatment, suggesting unmet need in this population.
Insights
Older men with overactive bladder (OAB) medication changed treatments sooner than those with benign prostatic obstruction (BPO) drugs. Most patients discontinued initial therapy, indicating an unmet need for effective OAB and BPO treatments.
Area of Science:
- Geriatric medicine
- Urology
- Pharmacology
Background:
- Overactive bladder (OAB) and benign prostatic obstruction (BPO) are common conditions in older men.
- Current treatments for OAB and BPO involve medications with varying efficacy and side effect profiles.
- Understanding treatment patterns and healthcare resource utilization is crucial for optimizing care in this population.
Purpose of the Study:
- To characterize the initial therapeutic changes and healthcare resource utilization among older men starting OAB or BPO medications.
- To compare treatment patterns and associated costs between OAB and BPO medication initiators.
Main Methods:
- Retrospective cohort study using health administrative data in Ontario, Canada (2010-2018).
- Included men aged ≥66 years with ≥1 OAB or BPO medication prescription.
- Characterized treatment changes, costs, and healthcare resource utilization pre- and post-index date.
Main Results:
- The OAB group (antimuscarinics) had a higher likelihood and shorter time to first therapeutic change compared to the BPO group (alpha-blockers).
- Most patients in both groups discontinued their first-line therapy (OAB: 75.6%; BPO: 69.9%).
- The OAB group incurred higher mean healthcare costs both pre- and post-index compared to the BPO group.
Conclusions:
- Older men initiating OAB medications tend to switch therapies more rapidly than those initiating BPO medications.
- A significant proportion of patients discontinue first-line OAB and BPO therapy without subsequent treatment, suggesting a substantial unmet need.
- Further research is needed to identify more effective and sustainable treatment strategies for OAB and BPO.
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