Overactive Bladder | Treatment Algorithms | Claims Data Analysis | US | 2015

Overactive bladder (OAB) is a common symptom complex characterized by urinary urgency, incontinence, frequency, and nocturia, which occur in the absence of pathologic or metabolic factors that could otherwise explain such symptoms. OAB is estimated to affect 43 million U.S. adults, although only 36% of prevalent cases are diagnosed. Nonpharmacological and pharmacological treatment approaches aim to reduce urinary symptoms and improve patients’ quality of life. Pharmacological treatments include antimuscarinic therapies (e.g., oral oxybutynin [generics], Astellas Pharma’s Vesicare [solifenacin succinate]); eight such therapies are approved to treat OAB in various oral, topical, or patch formulations. The competition for OAB patient share has increased following the launch of more-tolerable generic options (e.g., tolterodine tartrate), as well as new agents with novel mechanisms of action, including the first-in-class beta3 adrenergic receptor agonist Astellas Pharma’s Myrbetriq (mirabegron) in 2012 and Allergan’s injectable neurotoxin Botox (onabotulinumtoxinA) in 2013.

Using national patient-level claims data, Treatment Algorithms in Overactive Bladder explores the use of key therapies and drug classes among newly diagnosed and recently treated OAB patient populations. In the case of newly diagnosed patients, we provide a quantitative analysis of percentage drug-treated and time to treatment, treatment patterns and share by line of therapy, progression between lines, recent patient-share trends, and use of concomitant treatment. For recently treated patients, we quantify a drug’s overall drug share, use in combination with other therapies, and source of business compared with its competitors, detailing which drugs precede others through an analysis of add-versus-switch patterns. Two additional claims database queries explore persistency and compliance by therapy.