OBJECTIVES:  Despite the high prevalence of overactive bladder (OAB) in ageing population, this issue is not sufficiently noticed by health policy makers in Poland. According to current estimates, urinary incontinence affects more than 16.3% of people in Poland, but reimbursement of effective therapy is possible only after painful for the patient, unnecessary according to clinical guidelines urodynamic testing. Cost-of-illness analyses showed the huge economic burden related to OAB for public healthcare systems, patients and society, secondary to both direct and indirect costs. The objective of this study was to assess the scale of the problem in terms of costs in Poland. METHODS: A decision model was used to estimate the cost of the treatment of all OAB patients from the Polish National Health Fund (NFZ), patient and the societal perspectives, using a one-year horizon. Outcomes included direct medical costs (urodynamic testing, drugs, outpatient visits, incontinence products) and lost productivity (employers only). RESULTS: The overall cost associated with OAB was greater than €11 (from the NFZ perspective) and €276 million from the patient perspective (which includes €270 million for incontinence products). Given that most people with OAB do not seek medical treatment (9 years to first visit) it is not surprising that self-management is a very large cost. From the societal perspective, including direct medical and indirect costs (i.e., lost productivity), current overall spending on OAB management is €1 billion. Lost productivity costs due to OAB are very significant (72% of the overall cost from the societal perspective). CONCLUSIONS: Taking into account the costs incurred for the treatment of patients with OAB and limited patient access to effective drugs, there is a need for action by the Polish decision-makers in the area of OAB.