Prescribing Patterns for Beta-3 Agonists and Anticholinergic Medications Used in Treatment of Overactive Bladder

To better understand prescribing patterns of several anticholinergic and beta-3 agonist medications used in treatment of overactive bladder through analysis of a large national provider database.

We conducted a retrospective review of 2013-2023 Medicare Part D claims data in conjunction with Centers for Medicare & Medicaid Services-published data on Medicare-enrolled provider characteristics. Primary outcomes included whether there was a significant difference in the spread of provider characteristics within each medication- or class-specific subset compared to the overall cohort. Univariate analysis was conducted using one-sample proportion testing.

257,929 unique providers prescribed medications for overactive bladder between 2013 and 2023. Most prescribers were located in major metropolitan areas and urologists consistently comprised roughly 7% of the overall cohort. The number of advanced practice providers increased nearly 190% over the study period. More Urologists and OBGYNs utilized beta-3 agonists, particularly in the first 3 years after a drug's FDA approval. Beta-3 agonist use was highest among urban prescribers (P <.01), with early adoption of Mirabegron and Vibegron showing particularly pronounced urban predominance.

Uptake of newer medications remains limited, particularly among nonspecialists and in nonurban areas. These findings suggest that while newer drugs show distinct prescribing patterns, older medications remain widely prescribed due to broader adoption across specialties and practice settings.