Introduction

BPH and OAB are highly prevalent conditions that place a large burden on the US health care system. Medical management is the mainstay of therapy for both conditions, but few datasets are available that analyze patterns of medication usage and long-term persistence. This study analyzes patterns of prescription medication usage for incident BPH in men and incident OAB in men and women using US observational data.

Methods

Truven Health MarketScan® Commercial and Medicare Supplemental Research databases include de-identified medical claims and prescription drug claims for individuals in the US with employer-sponsored health insurance, as well as individuals with Medicare supplemental coverage. The data are pooled from diverse points of care, including large employers, managed care organizations, hospitals, and public organizations, thus providing greater generalizability than single payer databases. Men age 18+ had incident BPH with 2 diagnoses of BPH ?30 days apart and no BPH diagnosis for 1 year prior, based on ICD-9 codes for BPH, bladder neck obstruction, urinary retention, and incomplete bladder emptying. Men and women age 18+ were diagnosed similarly with incident OAB, based on ICD-9 codes for OAB symptoms (urinary frequency, urgency, nocturia, urge incontinence). Other criteria included continuous enrollment for 1 year before and 6 months after the first diagnosis date. Medication continuation (persistence), switching, and discontinuation were analyzed through September 30, 2013.

Results

31,701 women and 7,208 men were prescribed OAB medication; 69,079 men were prescribed medication for BPH (Table 1). Medication persistence was much higher overall for BPH than OAB (56% vs 34%, respectively), and was highest among men with BPH age 65+ (62%). Patients age 18-64 were less likely to continue medication than older adults (age 65+) for both BPH and OAB.

Conclusions

Persistence was higher with BPH than OAB medications overall, likely reflecting a combination of better efficacy and tolerability of BPH medications.

Funding

none