INTRODUCTION: This was a retrospective database study to identify prescription treatment patterns for OAB in a managed care population. METHODS: The two-year intake period was January 1, 2001 to December 31, 2002. Members with =1 diagnosis code for OAB in medical claims and/ or =1 prescription claim for an OAB drug were included. All claims were collected 1 year pre- and =1 year post-index. RESULTS: A study cohort of 19,486 OAB patients was identified, representing a 2% prevalence rate. The population was predominantly female (66%); mean age was 56 years. Most (86%) were new OAB cases. Long-acting OAB antimuscarinic medications were most frequently prescribed. Among new OAB patients, 30% had =1 OAB-related prescription claim(s) during follow-up. Only 9% of new OAB patients were initiated on OAB therapy after index date; mean time to initiation was 137 days (median 50 days). Most new OAB patients (96%) discontinued all OAB medication; mean time to discontinue was approximately two-months (median one-month). Few patients were continuously on OAB therapy (4%), switched, or added on a drug other than the initial OAB drug (15%). CONCLUSIONS: There appears to be lack of pharmacological intervention in OAB patients. Overall, patients were slow to initiate treatment, remained on drug therapy briefly, and most discontinued treatment. This may reflect intolerance of OAB pharmacological options and/ or lack of efficacy, non-pharmacological management, a perception among patients and/ or physicians that OAB symptoms have little impact on quality of life, or OAB patients may wait until symptoms become severe before requesting treatment.