Broadstreet Health Economics and Outcomes Research, Vancouver, British Columbia, Canada.
Astellas Pharma Global Development, Inc., Northbrook, Illinois.
Neurourol Urodyn. 2018 Apr;37(4):1241-1249. doi: 10.1002/nau.23477. Epub 2018 Jan 13.
Overactive bladder (OAB) affects up to 17% of the United States (US) population. This study aimed to synthesize estimates of direct and indirect costs of OAB in the US and compare costs among those with and without OAB.
A systematic review was performed using MEDLINE/PubMed and Embase, from 2003 to 2016, following PRISMA guidelines. The target population was adults with idiopathic OAB or urge urinary incontinence from the US. Data were extracted on study and patient characteristics, all-cause and OAB-specific direct costs, resource use, and indirect costs. Costs were inflated to a common price year of 2016 USD.
Eighteen studies were included. Mean insurer paid all-cause total direct healthcare costs ranged from 8168 to 15 569 USD, and OAB-specific costs ranged from 656 to 860 USD per-patient annually. Estimates of the incremental costs for OAB patients compared to non-OAB comparators ranged from 43% to 117%. One study estimated total annual indirect costs of OAB at 11 134 USD per-patient.
The range of direct healthcare costs reported for managing patients with OAB varied, but was relatively small given the differing contributing data sources, study designs, and cost definitions. Direct costs were consistently higher among patients with OAB versus non-OAB comparisons, from a 1.4- to >2-fold increase annually. OAB-specific costs made up a small proportion of all-cause costs, highlighting the clinical and economic impact of OAB-related conditions such as falls, urinary tract infection, and depression. Few studies were identified that examined the indirect costs of OAB in the US.
膀胱过度活动症（OAB）影响了美国（US）多达 17%的人群。本研究旨在综合评估美国 OAB 的直接和间接成本，并比较 OAB 患者与非 OAB 患者的成本。
根据 PRISMA 指南，从 2003 年到 2016 年，我们在 MEDLINE/PubMed 和 Embase 上进行了系统评价。目标人群是来自美国的特发性 OAB 或急迫性尿失禁的成年人。我们提取了研究和患者特征、全因和 OAB 特定的直接成本、资源使用情况和间接成本的数据。成本已换算为 2016 年的通用美元价格。
纳入了 18 项研究。保险公司支付的全因总直接医疗保健成本中位数从 8168 美元到 15569 美元不等，OAB 特定成本中位数从每位患者每年 656 美元到 860 美元不等。与非 OAB 对照组相比，OAB 患者的增量成本估计范围从 43%到 117%不等。一项研究估计 OAB 患者的总年度间接成本为每位患者 11134 美元。
尽管不同的研究数据源、研究设计和成本定义存在差异，但报告的管理 OAB 患者的直接医疗保健成本范围相对较小。与非 OAB 比较组相比，OAB 患者的直接成本始终更高，每年增加 1.4 至 2 倍以上。OAB 特定成本占全因成本的比例较小，突出了 OAB 相关疾病（如跌倒、尿路感染和抑郁）的临床和经济影响。我们发现很少有研究检查了美国 OAB 的间接成本。
