Persistence of Anticholinergic Agents in Patients With Overactive Bladder: A Cohort Study From the French National Health Insurance Claim Database (SNDS)
Author(s)
Adrien Gerbaud, PharmD1, Meriem Boussahoua, PharmD1, Alexandre Vimont, MSc2, Manon Santrisse, Engineer2, Henri Leleu, PhD, MD2, Christophe Pignier, MD1, Laurent Bardin, PhD1, Sylvie ABBADIE, PharmD1.
1Pierre Fabre Médicament, Boulogne, France, 2Public Health Expertise, Paris, France.
1Pierre Fabre Médicament, Boulogne, France, 2Public Health Expertise, Paris, France.
OBJECTIVES: Anticholinergics (ACH) are the first-line treatment for overactive bladder (OAB). As data from real world utilization are scarce, the objective of this study was to assess treatment persistence of ACH in adult patients in France and to describe treatment patterns.
METHODS: This longitudinal, retrospective study used a 2% representative sample of the French National Medico-administrative Claim Database (SNDS). Total population included treatment-naïve adult patients initiating ACH in 2021 and 2022, and the analysis population with at least 3 months of follow-up was considered. Treatment duration was defined as the time between first and last delivery of the same ACH without discontinuation, define as at least 3 months free of ACH dispensing. Demographics, comorbidities, prescribers and subsequent treatments were described. A subgroup analysis was conducted in patients with at least 1 year of follow-up.
RESULTS: A total of 9,835 naïve patients initiating ACH were included, with a median age of 68 years (28.9% above 75 years), 58.0% were women and 62.4% had at least one comorbidity, including 41.2% with hypertension. Solifenacin was the most prescribed at initiation (41.4%), followed by fesoterodine (38.4%). The median treatment duration was 1 month (Q1-Q3 [1.0;4.0]), corresponding to a single delivery for 55.4% of patients. Only 27.6% of patients had more than 3-month of treatment duration. The subgroup analysis showed that 82.5% remained without treatment after more than a year of follow-up. ACH were mostly prescribed by general practitioners (GP) (61.6%) followed by urologists (22.6%). GP visits increased after ACH initiation, from 4 times monthly before initiation to 7 times before ACH discontinuation.
CONCLUSIONS: This study reveals limited persistence with ACH in the management of OAB in France. Most patients discontinued after a single delivery and remained without OAB treatment after 1-year of follow-up. These results highlight the need for strategies addressing treatment optimization and maintaining treatment adherence.
METHODS: This longitudinal, retrospective study used a 2% representative sample of the French National Medico-administrative Claim Database (SNDS). Total population included treatment-naïve adult patients initiating ACH in 2021 and 2022, and the analysis population with at least 3 months of follow-up was considered. Treatment duration was defined as the time between first and last delivery of the same ACH without discontinuation, define as at least 3 months free of ACH dispensing. Demographics, comorbidities, prescribers and subsequent treatments were described. A subgroup analysis was conducted in patients with at least 1 year of follow-up.
RESULTS: A total of 9,835 naïve patients initiating ACH were included, with a median age of 68 years (28.9% above 75 years), 58.0% were women and 62.4% had at least one comorbidity, including 41.2% with hypertension. Solifenacin was the most prescribed at initiation (41.4%), followed by fesoterodine (38.4%). The median treatment duration was 1 month (Q1-Q3 [1.0;4.0]), corresponding to a single delivery for 55.4% of patients. Only 27.6% of patients had more than 3-month of treatment duration. The subgroup analysis showed that 82.5% remained without treatment after more than a year of follow-up. ACH were mostly prescribed by general practitioners (GP) (61.6%) followed by urologists (22.6%). GP visits increased after ACH initiation, from 4 times monthly before initiation to 7 times before ACH discontinuation.
CONCLUSIONS: This study reveals limited persistence with ACH in the management of OAB in France. Most patients discontinued after a single delivery and remained without OAB treatment after 1-year of follow-up. These results highlight the need for strategies addressing treatment optimization and maintaining treatment adherence.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD85
Topic
Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Urinary/Kidney Disorders