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Am J Manag Care. 2009 Mar;15(4 Suppl):S90-7.

The total economic burden of overactive bladder in the United States: a disease-specific approach.

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Department of Pharmaceutical Health Services Research, University of Maryland, School of Pharmacy, 220 Arch St, Baltimore, MD 21201, USA.



To employ results from a recent US population-based survey to calculate disease-specific total costs of overactive bladder (OAB).


Disease-specific total cost-of-illness method using population prevalence estimates.


Cases were identified as community-dwelling adults reporting the presence of urinary urgency or urgency urinary incontinence. Two OAB classifications were used based on Likert scale responses of OAB symptoms: "often" (base case) or "sometimes" (alternative). The study estimates disease-specific total costs of OAB from the societal perspective and using an average costing method. A population-based survey, a claims data analysis, and the published literature provided the prevalence and resource utilization data.


The prevalence of OAB as defined in the base case (alternative) was 18.6% (28.7%) in the adult US population, accounting for 42.2 million (65.1 million) community-dwelling adults. The disease-specific total cost of OAB is estimated at $24.9 billion for the base case and $36.5 billion for the alternative case. Total direct costs were $22.3 billion in the base case and $33.5 billion in the alternative case. Costs were higher among adults younger than 65 years of age, compared with adults 65 years or older. This relative cost burden was lower for the base case compared with the alternative case in the full sample, with a larger gap among men.


The total cost of OAB among community-dwelling adults is significant and varies with demographic groups. Future research is needed to determine whether the differential cost burden is robust to alternate cost-of-illness estimation methods.

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