Burden On Secondary Care Of Overactive Bladder Patients Who Are Inadequately Managed With Anticholinergics In England.

LPD from Taiwan health care payer’s perspective. Methods: A Markov was designed to simulate outcomes of two options in a hypothetical cohort of adult CKD patients with eGFR 15-29 mL/min/1.73m2: (1) Initiation of LPD plus KA, and (2) watchful-waiting on LPD and initiation of KA at eGFR < 15 mL/min/1.73m2. The Markov states included CKD stage 4 and 5, hemodialysis, and death. Total direct medical cost and qualityadjusted life-years (QALYs) gained were calculated over a maximum period of 10 years. Model inputs were derived from literature. Sensitivity analyses evaluated the impact of uncertainty in all model variables. Results: In base-case analysis, early KA initiation group (3.926 QALYs and USD548,191) gained higher QALYs and cost less than the watchful-waiting group (3.787 QALYs and USD887,608) (USD1= NTD30). Sensitivity analysis indicated that early KA initiation at eGFR at 17-29 mL/min/1.73m2 would be the preferred cost-effective option if reduction of eGFR decline associated with LPD plus KA was 4% or above. When KA was initiated at eGFR 15-17 mL/min/1.73m2, it would remain cost-effective if the reduction of eGFR decline associated with LPD plus KA was 13.5% or above. 10,000 Monte Carlo simulations showed early KA initiation group to be less costly with higher QALY gained than watchful-waiting group by USD333,655 (95% CI 332,174-335,137) and 0.160 (95% CI 0.140-0.180) QALYs, respectively. ConClusions: KA Initiation with LPD in CKD patients as early as eGFR 15-29 mL/min/1.73m2 seems to be cost-effective in Taiwan.