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Fall/Fracture-Related Healthcare Costs and Their Association with Cumulative Anticholinergic Burden in People with Overactive Bladder

Author

Listed:
  • Greta Lozano-Ortega

    (Broadstreet Health Economics and Outcomes Research)

  • Carol R. Schermer

    (Astellas Pharmaceutical Global Development Inc.)

  • David R. Walker

    (Astellas Pharmaceutical Global Development Inc.)

  • Shelagh M. Szabo

    (Broadstreet Health Economics and Outcomes Research)

  • Basia Rogula

    (Broadstreet Health Economics and Outcomes Research)

  • Alison M. Deighton

    (Broadstreet Health Economics and Outcomes Research)

  • Katherine L. Gooch

    (Astellas Pharmaceutical Global Development Inc.)

  • Noll L. Campbell

    (Purdue University)

Abstract

Background Falls/fractures are major causes of morbidity and mortality among older adults and the resulting health consequences generate a substantial economic burden. Risk factors are numerous and include overactive bladder (OAB) and anticholinergic use. Objectives We aimed to estimate the impact of falls/fractures on all-cause healthcare resource utilization and costs, according to levels of cumulative anticholinergic burden, among individuals with OAB. Methods Among a US cohort of adults with OAB (identified based on medical claims for OAB or OAB-specific medications), the frequency of resource utilization (outpatients visits, medication use, and hospitalizations) was examined according to level of anticholinergic burden. Anticholinergic burden was assessed cumulatively using a published measure, and categorized as no, low, medium, or high. Resource utilization prior to and after a fall/fracture was compared. Generalized linear models were used to examine overall and incremental changes in healthcare resource utilization and costs by fall/fracture status, and annual costs were predicted according to age, sex, fall/fracture status, and level of anticholinergic burden. Results The mean age of the OAB cohort (n = 154,432) was 56 years, 68% were female, and baseline mean anticholinergic burden was 266.7 (i.e. a medium level of burden); a fall/fracture was experienced by 9.9% of the cohort. All estimates of resource utilization were higher among those with higher levels of anticholinergic burden, regardless of fall/fracture status, and higher for all levels of anticholinergic burden after a fall/fracture. Among those with a fall/fracture, the highest predicted annual costs were observed among those aged 66–75 years with high anticholinergic burden (US$22,408 for males, US$22,752 for females). Conclusions Falls/fractures were associated with higher costs, which increased with increasing anticholinergic burden.

Suggested Citation

  • Greta Lozano-Ortega & Carol R. Schermer & David R. Walker & Shelagh M. Szabo & Basia Rogula & Alison M. Deighton & Katherine L. Gooch & Noll L. Campbell, 2021. "Fall/Fracture-Related Healthcare Costs and Their Association with Cumulative Anticholinergic Burden in People with Overactive Bladder," PharmacoEconomics - Open, Springer, vol. 5(1), pages 45-55, March.
  • Handle: RePEc:spr:pharmo:v:5:y:2021:i:1:d:10.1007_s41669-020-00215-w
    DOI: 10.1007/s41669-020-00215-w
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    References listed on IDEAS

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    1. Anirban Basu & Willard G. Manning & John Mullahy, 2004. "Comparing alternative models: log vs Cox proportional hazard?," Health Economics, John Wiley & Sons, Ltd., vol. 13(8), pages 749-765, August.
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    1. Journal round-up: PharmacoEconomics – Open 5(1)
      by Rita Faria in The Academic Health Economists' Blog on 2021-04-29 06:00:05

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