Abstract
Objectives
To investigate whether the 2010 introduction of percutaneous tibial nerve stimulation
and the 2013 introduction of intradetrusor onabotulinumtoxinA were associated with
an increase in overall utilization of third-line treatments.
Methods
Using medical claims data from IBM Marketscan database 2010-2019, diagnosis codes
were used to identify adult women with overactive bladder. Procedure codes were used
to identify third-line treatments. The annual proportion of patients receiving third-line
treatments was calculated, as well as the proportion of each treatment received. These
were modeled as a function of treatment year using linear regression; a regression
coefficient significantly different from zero was considered evidence of a significant
change in utilization over time.
Results
We identified 3,067,515 unique individuals with a diagnosis of overactive bladder,
including 14,652 who initiated third-line treatments. The annual percentage of women
with overactive bladder who initiated third-line treatment was 0.18% and did not change
significantly over 10 years (p=0.82). However, the proportion receiving sacral neuromodulation
decreased significantly (p<0.001), with a compensatory increase in intradetrusor onabotulinumtoxinA.
Specifically, within 6 years of its introduction, onabotulinumtoxinA accounted for
almost half of third-line treatments initiated.
Conclusions
Overall, third-line therapies for non-neurogenic overactive bladder are utilized infrequently
among privately insured women. Over the past decade, the introduction of new treatment
options has led to a shift in the type of treatment initiated, rather than to an increase
in the overall utilization of third-line therapies.
Keywords
Abbreviations:
AUA (American Urologic Association), BTX (intradetrusor chemodenervation with onabotulinum toxin A), CCAE (Commercial Claims and Encounters), CPT (Current Procedural Terminology), FDA (Food and Drug Administration), ICD (International Classification of Disease), IRB (Institutional Review Board), OAB (overactive bladder), PTNS (percutaneous tibial nerve stimulation), SNM (sacral neuromodulation), SUFU (society of urodynamics, female pelvic medicine & urogenital reconstruction)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
November 8,
2022
Received:
October 25,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Declaration of interests: None
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
