OBJECTIVES: To determine the impact of sacral neuromodulation (SNM) on EQ-5D index scores and OAB management costs using an Economic Impact Questionnaire (EIQ) in patients who failed at least one anticholinergic medication enrolled in the InSite study, an ongoing, prospective, multicenter trial of SNM. METHODS: EQ-5D and EIQ were administered at baseline, 3-, 6- and 12-months post-implant. OAB-related expenses included durable and disposable medical supplies and health service utilization (emergency room, hospitalizations and outpatient).  340 patients completed the SNM pre-implant evaluation; data from 265 subjects were included in EQ-5D or EIQ analyses. Matched paired t-tests compared EQ-5D scores and costs from baseline to each follow-up. RESULTS: Baseline mean EQ-5D index score (n=265) was 0.777. Index scores significantly improved (p<0.05) from baseline at each follow-up period [3-months (n=247)=0.850, 6-months (n=246)=0.828, and 12-months (n=232)=0.839]; the largest improvement in scores (0.073) was at 3 months.  The proportion of patients reporting no problems on the EQ-5D dimensions of Usual Activities, Anxiety/Depression and Pain/Discomfort and Self-Care increased from 61.2% (baseline) to 72.0% (12 months); 57.3% to 69.4%; 40.9% to 50.9%, and 93.1% to 95.3%, respectively; the Mobility dimension had a non-significant decline (68.5% to 66.4%). At baseline, study subjects reported a 3-month average expenditure of $228 (US) for durable and disposable medical supplies and health service utilization; 74% of the expenditure was attributed to ER, hospitalization and outpatient health services use. Expenditures significantly declined (p<0.05) by an average of $163 per 3-month period post-implant.  CONCLUSIONS: After receiving SNM implant, EQ-5D index scores were significantly improved and self-reported durable and disposable medical supplies and health service expenses to manage OAB were significantly reduced.