Chemodenervation Use for Overactive Bladder in Female Medicare Beneficiaries

Area of Science:

• Urology
• Health Services Research
• Health Equity

Background:

• Overactive bladder (OAB) affects a significant number of women, yet effective treatments remain underutilized.
• Intradetrusor chemodenervation is an effective treatment option for OAB.
• Disparities in access to OAB care, particularly advanced treatments, are a concern.

Purpose of the Study:

• To investigate the utilization of intradetrusor chemodenervation for OAB among female Medicare beneficiaries.
• To compare treatment rates across different racial and ethnic groups.
• To identify factors associated with receiving this OAB treatment.

Main Methods:

• Retrospective cohort study using Medicare data (2012-2020) of women aged 65+ with OAB.
• Analysis of cumulative incidence of intradetrusor chemodenervation within 5 years of OAB diagnosis.
• Cox regression to identify predictors of treatment receipt and adjust for confounders.

Main Results:

• Low overall utilization of intradetrusor chemodenervation (1.4%) within 5 years of OAB diagnosis.
• Significantly lower treatment rates observed in Asian (0.6%), Black (0.7%), Hispanic (0.7%), and Other (0.9%) racial/ethnic groups compared to White women.
• Adjusted analyses revealed lower likelihood of treatment for non-White and Hispanic women (aHRs ranging from 0.51 to 0.62).

Conclusions:

• Intradetrusor chemodenervation utilization is low nationally.
• Racial and ethnic disparities exist, with non-White women receiving this OAB treatment less frequently.
• Further investigation into patient barriers and interventions to improve access to OAB care is warranted.