Sex- and Age-Specific Trends in Prescriptions of Beta-3 Agonists and Anticholinergics in Japan: A Nationwide Prescription Database Study.

INTRODUCTION

To investigate the nationwide trends in pharmacological treatment for overactive bladder among Japanese adults, specifically focusing on the β3-agonists to anticholinergics prescribed tablet ratio (BAPR) and how this ratio differs by sex and age.

METHODS

National Database Open Data from fiscal year 2015 to 2023 were utilized and the prescription volumes of β3-agonists (mirabegron and vibegron) and anticholinergics (propiverine, solifenacin, imidafenacin, and fesoterodine) were aggregated. The data were categorized by sex and 10-year age groups to analyze prescribed tablet trends per 1000 population for each demographic. We calculated the BAPR by dividing the number of prescribed tablets for β3-agonists by those for anticholinergics and investigated the annual trends for younger and older men and women using an ordinary least squares linear regression model.

RESULTS

During the study period, the total number of prescribed tablets for β3-agonists, anticholinergics, and overall total showed changes of +285.3%, -24.7%, and +59.3%, respectively. Total and β3-agonist prescriptions rose annually across all groups, whereas anticholinergic use declined beginning in fiscal year 2018. Additionally, nearly all drugs showed an increase in prescribed tablets per 1000 population as age progressed. Although the BAPR increased significantly in all groups, there were significant differences in the rates of change between groups (p < 0.001), with older men exhibiting the highest rate of increase.

CONCLUSIONS

A nationwide shift in overactive bladder treatment, where the growth in β3-agonist prescriptions outweighed the decline in anticholinergics, was observed across all demographic groups in Japan.