Objective: To evaluate the cost-effectiveness of solifenacin 5 mg/day versus other oral antimuscarinic agents used for overactive bladder (OAB) from a UK National Health Service (NHS) perspective. Study design: In a Markov model, hypothetical patients received solifenacin 5 mg/day or a comparator antimuscarinic, after which they could switch to an alternative antimuscarinic. The model estimated incremental cost-effectiveness ratios (ICER), expressed as cost per quality-adjusted life year (QALY) over a 5-year period. Results: Solifenacin 5 mg/day was the dominant treatment strategy (i.e., less costly and more effective) versus tolterodine extended-release (ER) 4 mg/day, fesoterodine 4 and 8 mg/day, oxybutynin ER 10 mg/day and solifenacin 10 mg/day, and was cost-effective (i.e., ICERs below the £30,000 per QALY threshold generally applied in the NHS) versus oxybutynin immediate release (IR) 10 mg/day, tolterodine IR 4 mg/day and trospium chloride 60 mg/day. The probability of solifenacin 5 mg/day being dominant/cost-effective at a willingness-to-pay threshold of £30,000 per QALY was 57-98%. Conclusions: Solifenacin 5 mg/day appears to be a cost-effective strategy for the treatment of OAB over a 5-year timeframe compared with other oral antimuscarinic agents in the UK. These findings are important for decision-makers considering the economic implications of selecting treatments for OAB.
Journal of market access & health policy. 2018 Mar 20*** epublish ***
Zalmai Hakimi, Con Kelleher, Samuel Aballéa, Khaled Maman, Jameel Nazir, Colette Mankowski, Isaac Odeyemi
Medical Affairs Department, Astellas Pharma Europe B.V, Leiden, The Netherlands., Department of Obstetrics and Gynecology, Guy's and St. Thomas' NHS Foundation Trust, London, UK., Health Economics and Outcomes Research Department, Creativ-Ceutical SARL, Paris, France., Health Economics and Outcomes Research Department, Creativ-Ceutical Ltd, London, UK., Medical Affairs Department, Astellas Pharma Europe Ltd, Chertsey, UK.