OBJECTIVES: Comparing the costs of Solifenacin, Oxybutynin, Trospium chloride, Tolterodine, Propiverine, and Darifenacine for the treatment of overactive bladder (OAB) and incontinence in Germany. DATA AND METHODS: The cost-study is based on a unique sickness fund dataset of 2.9 million insured persons which included pharmaceutical, outpatient, inpatient, medical aids as well as remedies data in 2009. 25,896 persons received anticholinergics and were classified as OAB patients. 4,152 of these patients also suffered from incontinence. Multiple linear regression models were performed to control for age and gender effects. Furthermore, a general approach (all costs were included) as well as a specific approach (only costs associated with OAB were considered) were used. RESULTS: OAB patients caused additional costs of €2,492 using the general and €782 using the specific approach compared to Non-OAB patients. Patients treated with Propiverine (€1,854) had the lowest additional costs under the general approach and patients treated with Darifenacine (€3,230) the highest. In the specific approach, patients treated with Propiverine (€691) had the lowest additional costs and patients treated with Tolterodine (€1,124) the highest. In the special case of incontinence, patients treated with Solifenacin have shown, by far, the lowest additional costs using either approach (€3,216; €1,320). These results are mainly driven by the lower costs of aids, especially due to the lower pad usage. Patients treated with Trospium chloride (€5,409) exhibited the highest costs using the general approach and patients treated with Tolterodine (€2,198) incurred the highest costs using the specific approach. All results were highly significant (p<0.01). CONCLUSIONS: This study compares the costs of six anticholinergics for the treatment of OAB and incontinence in Germany. OAB patients treated with Propiverine and incontinent patients treated with Solifenacin have shown the lowest additional costs. For both patient groups Tolterodine is associated with the highest additional cost of treatment.