OBJECTIVES: Overactive bladder (OAB) is a life-long disease that recognized by urinary urgency, increased frequency of urination, enuresis, nocturia, and in some cases urinary incontinence OAB can interfere with health-related quality-of-life especially in geriatric. The current treatment for OAB include conservative management, surgery therapy, and pharmacotherapy. Pharmacotherapy options are Antimuscarinics such as tolterodine and oxybutynin as the first-line medication. Mirabegron is a new drug acting by the mechanism of ß3-adrenoceptor agonism. This study was aimed to evaluate cost-effectiveness of Mirabegron in the OAB patients.

METHODS: We searched published articles in databases including PubMed, Scopus, Google Scholar, and ScienceDirect to identify the studies. All the search results were screened for the relevance of the inclusion criteria. Eligible studies was economic Mirabegron analyses. Primary outcomes were quality-adjusted life-years (QALY), costs, and incremental cost-effectiveness ratio (ICER).

RESULTS: Of the nine studies in six studies, mirabegron was a cost-effective option. Therefore, in most cases, mirabegron regimen is cost-saving in different perspectives and time horizons. Although, in one study, fesoterodine was cost-effective. Another two studies that compared fesoterodine with mirabegron, demonstrated that mirabegron was cost-effective (Fesoterodine 4mg: £3632.82/QALY; 8mg: £3315.42/QALY). But the difference in QALYs showed that the effectiveness of thirdline therapies in controlling the disease and improving the health-related quality of life was much better than all pharmacotherapies including mirabegron. Although Societal perspective is the best choice for pharmacoeconomic analyses due to the inclusion of all costs and health outcomes. Among all included studies, only one study by Herschorn and co-workers utilized the societal perspective and others included costs from national health system and payer perspectives.

CONCLUSIONS: This is the first systematic review of the cost-effectiveness of mirabegron for patients with OAB compared with all treatment strategies. Based on the stated query, we concluded that in OAB patients, mirabegron is a cost-effective option in comparison with current antimuscarinics.