Caro Research Institute, Hammonds Plains, Nova Scotia, Canada.
Clin Drug Investig. 2004;24(2):81-8. doi: 10.2165/00044011-200424020-00003.
To evaluate the cost-effectiveness of a new extended-release (XL) formulation of oxybutynin relative to tolterodine immediate release (IR), currently the most prescribed treatment for overactive bladder in the UK.
A state-transition model was developed to compare outcomes over 1 year. Effectiveness and treatment persistence data were derived from the OBJECT (Overactive Bladder: Judging Effective Control and Treatment) study, a 3-month clinical trial comparing oxybutynin XL 10 mg/day with tolterodine IR 4 mg/day. The daily costs of oxybutynin XL and tolterodine IR were pound0.82 and pound1.04, respectively. These data and information from the literature were used to project outcomes beyond the trial time. Severity-specific incontinence cost profiles were developed for the UK (2002 costings).
After 1 year, 3.1 more patients per 100 treated attained complete continence with oxybutynin XL compared with tolterodine IR, and 5.6% more had less than seven incontinent episodes per week. Over 1 year, patients receiving oxybutynin XL had almost 17 additional incontinence-free days and 95 fewer incontinent episodes. Estimated costs were pound86 lower per patient with oxybutynin XL. If drugs are priced equally, savings decrease to pound21 per patient. Oxybutynin XL maintains its advantage over wide ranges of inputs, and outcomes are similar if analyses are limited to 3 months.
Base-case analyses suggest that oxybutynin XL provides better effectiveness than tolterodine IR and reduces costs. Results indicate that oxybutynin XL is the dominant therapeutic option under a wide range of alternative inputs and assumptions.
评估与目前在英国最常用于治疗膀胱过度活动症的托特罗定即释剂相比，奥昔布宁新的延长释放（XL）制剂的成本效益。
开发了一个状态转移模型来比较 1 年的结果。疗效和治疗持久性数据源自 OBJECT（膀胱过度活动症：判断有效控制和治疗）研究，这是一项为期 3 个月的临床试验，比较了奥昔布宁 XL 10mg/天与托特罗定 IR 4mg/天的疗效。奥昔布宁 XL 和托特罗定 IR 的日费用分别为 0.82 英镑和 1.04 英镑。这些数据和来自文献的信息用于预测试验时间以外的结果。为英国（2002 年费用）制定了严重程度特异的尿失禁成本概况。
与托特罗定 IR 相比，奥昔布宁 XL 治疗的 100 名患者中，有 3.1 名患者在 1 年后达到完全无尿失禁，每周少于 7 次尿失禁的患者多 5.6%。1 年内，接受奥昔布宁 XL 治疗的患者有近 17 天无尿失禁，尿失禁次数减少 95 次。奥昔布宁 XL 每个患者的成本降低了 86 英镑。如果药物定价相同，每个患者的节省费用将减少到 21 英镑。奥昔布宁 XL 在广泛的输入范围内保持优势，并且如果分析仅限于 3 个月，则结果相似。
基础案例分析表明，奥昔布宁 XL 的疗效优于托特罗定 IR，并降低了成本。结果表明，在广泛的替代输入和假设条件下，奥昔布宁 XL 是占主导地位的治疗选择。
