Treatment Patterns in Men Prescribed Benign Prostatic Obstruction or Overactive Bladder Medications in Canada: A Retrospective Population-based Study

Urology, vol. 180, pp. 219–226

Abstract

OBJECTIVE: To characterize first therapeutic change and healthcare resource utilization in older men initiating an overactive bladder (OAB) or benign prostatic obstruction (BPO) medication. METHODS: A retrospective cohort study using health administrative data from ICES in Ontario, Canada (from April 01, 2010 to December 31, 2018) was conducted in men aged ≥66 years with ≥1 OAB (β3 agonist, antimuscarinic) or BPO (α-blocker, 5-α-reductase inhibitor) prescription and ≥1-year postindex data (index=first observed dispensation). EXCLUSIONS: prescriptions for these drugs ≤1 year preindex, a related procedure ≤5 years. Patients were grouped by condition based on index prescription. Treatment changes in relation to OAB and BPO were characterized by type. Costs and healthcare resource utilization pre- and post-index were compared. RESULTS: Age, geographic region, and income were similar between groups. The most common initial treatments were antimuscarinics (78.1%) in the OAB group and alpha-blockers (86.4%) in the BPO group. The OAB group was more likely to experience a therapeutic change and had a shorter time to first change in therapy (78 [30,231] vs 104 [30,350] days) and higher mean healthcare costs both pre- ($12,354 vs $11,497) and postindex ($14,423 vs $12,852). The most common first therapeutic change in both groups was discontinuing treatment (OAB: 75.6%; BPO: 69.9%). CONCLUSION: Men initiating OAB medications changed therapy sooner than those initiating BPO medications. Most discontinued first-line therapy without initiating further treatment, suggesting unmet need in this population.

Authors 7

1. Sarah Neu corresponding

   Sunnybrook Health Science Centre · University of Toronto

   Affiliation as printed

   Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

   Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada

2. Rano Matta corresponding

   Sunnybrook Health Science Centre · University of Toronto

   Affiliation as printed

   Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

   Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada

3. Jennifer A. Locke corresponding

   Sunnybrook Health Science Centre · University of Toronto

   Affiliation as printed

   Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

   Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada

4. Rodrigo Martins de Almeida corresponding

   Astellas Pharma (United Kingdom)

   Affiliation as printed

   Astellas Pharma Europe, Addlestone, UK

   Astellas Pharma Europe, UK

5. Matthias Stoelzel corresponding Aachen Astellas Pharma Europe B.V

   Astellas Pharma (Netherlands)

   Affiliation as printed

   Astellas Pharma Europe B.V., Leiden, Netherlands

   Astellas Pharma Europe B.V., Netherlands

6. Patrick J. O. Covernton corresponding

   Astellas Pharma (United Kingdom)

   Affiliation as printed

   Astellas Pharma Europe, Addlestone, UK

   Astellas Pharma Europe, UK

7. Sender Herschorn corresponding

   Sunnybrook Health Science Centre · University of Toronto

   Affiliation as printed

   Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. Electronic address: sender.herschorn@sunnybrook.ca

   Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada