Urogynecology (Philadelphia, Pa.) · 2026
Beta-3 Agonists Versus Anticholinergics: A Cost-effectiveness Analysis.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
St Martin Brad, Wallace Shannon L, Cadish Lauren A, Chang Olivia H, Sokol Eric R, Shepherd Jonathan P
Аннотация
IMPORTANCE: Medical treatment for overactive bladder (OAB) includes beta-3 agonists and anticholinergic medications; the latter of which has been associated with an increased risk of dementia. With dementia risks included, the cost-effectiveness of these medications has not been determined.
OBJECTIVE: The objective of this study was to evaluate 10-year costs, quality of life, and cost-effectiveness comparing beta-3 agonists to anticholinergics.
STUDY DESIGN: A Monte Carlo microsimulation (n=10,000) modeled treatment pathways of anticholinergics versus beta-3 agonists. Both strategies included opportunities to transition to a second same-class medication, third-line therapies, or discontinue treatment. Model inputs were derived from national databases and published literature. Quality-adjusted life-years (QALYs), cost, and incremental cost-effectiveness ratios (ICERs) were modeled from the health care perspective. Secondary outcomes evaluated the marginal increase in the incidence of dementia, time with dementia, and dementia-associated treatment cost.
RESULTS: Among patients using anticholinergics, an additional 1.9% developed dementia compared with beta-3 agonists, incurring an additional $250,092 per patient over 10 years. Beta-3 agonists were cost-effective (ICER=$9,132.26/QALY). Furthermore, beta-3 agonists were the dominant strategy, resulting in lower costs and higher QALYs, in 35.9% (3,586/10,000) of patients, compared with 32.3% utilizing anticholinergics.
CONCLUSIONS: Despite the increased medication cost of beta-3 agonists, the overall costs of treating OAB are comparable over 10 years. Broadened accessibility and coverage of these cost-effective treatments reduce risks and costs associated with dementia.
OBJECTIVE: The objective of this study was to evaluate 10-year costs, quality of life, and cost-effectiveness comparing beta-3 agonists to anticholinergics.
STUDY DESIGN: A Monte Carlo microsimulation (n=10,000) modeled treatment pathways of anticholinergics versus beta-3 agonists. Both strategies included opportunities to transition to a second same-class medication, third-line therapies, or discontinue treatment. Model inputs were derived from national databases and published literature. Quality-adjusted life-years (QALYs), cost, and incremental cost-effectiveness ratios (ICERs) were modeled from the health care perspective. Secondary outcomes evaluated the marginal increase in the incidence of dementia, time with dementia, and dementia-associated treatment cost.
RESULTS: Among patients using anticholinergics, an additional 1.9% developed dementia compared with beta-3 agonists, incurring an additional $250,092 per patient over 10 years. Beta-3 agonists were cost-effective (ICER=$9,132.26/QALY). Furthermore, beta-3 agonists were the dominant strategy, resulting in lower costs and higher QALYs, in 35.9% (3,586/10,000) of patients, compared with 32.3% utilizing anticholinergics.
CONCLUSIONS: Despite the increased medication cost of beta-3 agonists, the overall costs of treating OAB are comparable over 10 years. Broadened accessibility and coverage of these cost-effective treatments reduce risks and costs associated with dementia.