OBJECTIVES: To evaluate the annual health expenditure (AHE) in patients with neurogenic detrusor overactivity (NDO) after spinal cord injury (SCI). METHODS: Data containing 2 million randomly sampled individuals from the National Health Insurance Research Database (NHIRD) in Taiwan were used. Patients with emergency department visits or hospitalizations for SCI defined by ICD-9 codes 806.X and 952.X between 2006 and 2008 were retrieved. NDO was defined by: 1) diagnosis defined by ICD-9 codes 596.5 and 788.3 (excluding 596.53, paralysis of bladder); 2) pharmacological treatment for neurogenic voiding dysfunction and urinary symptoms such as alpha blockers, antimuscarinic agents, and cholinergic agents; and 3) procedures such as indwelling or intermittent catheterization defined by NHI codes 47,013C and 47,014C. All patients were followed for one year. The total AHE, as well as three subcategories, hospital, outpatient, and pharmacological treatment related cost were calculated respectively. Covariates including patient’s demographics, hospital length of stay, concomitant medications, and comorbid conditions were considered in the final linear regression to compare the AHE between NDO and non-NDO group. RESULTS: A total of 941 eligible individuals with SCI were identified from 2006 to 2008, of whom 165 (17.5%) were NDO cases with a mean age of 54 and consisting of 64% male. The total AHE was 494,325 (±499,259) and 108,529 (±147,287) N.T. dollars in NDO and non-NDO group, respectively. After adjusting by regression model, the total AHE was higher in NDO (β=364,611; SE=21,082; p<0.001) than non-NDO group. Higher AHE was also shown in NDO in each subcategory when comparing with non-NDO. CONCLUSIONS: A significant impact on the financial burden of NDO was shown in this study.  Higher AHE associated with NDO may also reflective of the higher severity of  SCI or other comorbid conditions.