OBJECTIVES: To quantify the cost-effectiveness of overactive bladder (OAB) treatment with fesoterodine (FESO) relative to extended release tolterodine (TER) and solifenancin (SOL) in Sweden based on recently-available data. METHODS: A 52-week decision-tree model was developed using data from four 12-week, randomized clinical trials and published literature. Patients who did not achieve resolution of urgency urinary incontinence (UUI) at week 4 were titrated to higher doses in the FESO and SOL model arms. TER is only available in one dose and all patients therefore remained on TER at week 4 regardless of UUI resolution. The published decrease in UUI episodes was used to estimate the proportion of UUI resolution with SOL. Trial discontinuation data were fit to a Weibull survival model and extrapolated to 52 weeks. Changes in health-related quality of life were assessed using Overactive Bladder Questionnaire data from two of the trials and were transformed into preference-based utility values. Regression analysis determinedthe association between trial utilities and micturition/UUI episodes in order to estimate values for SOL. Medical costs included antimuscarinic drugs, physician visits, laboratory tests, incontinence pads and costs of OAB- or incontinence-related comorbidities. Probabilistic sensitivity analysis was used to determine the impact of uncertainty in the model inputs on its outcomes. RESULTS: 19.5%, 18.0%, and 16.3% of patients receiving FESO, TER, and SOL, remained on treatment and were continent after 52 weeks. The respective quality-adjusted life years associated with FESO, TER, and SOL, were 0.762, 0.756 and 0.752; overall costs were kr16,752, kr16,849, and kr17,047, indicating that FESO is a lower-cost and more effective treatment option than TER and SOL. Sensitivity analysis confirmed the superiority of FESO in over 80% of model simulations. CONCLUSIONS: Results suggest FESO has lower costs and higher efficacy and thus  dominates both TER and SOL in treating OAB with UUI in Sweden.