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Has the cost of anti-muscarinic a key role in the success rate of patients diagnosed with overactive bladder syndrome?

INTRODUCTION
Overactive bladder syndrome (OAB) is a chronic disease, the prevalence in the general population is reported to be 14-16%. Anti-muscarinic agents are considered the first-line pharmacological treatment for the management of OAB; although a long lasting therapy is indicated to reach a better control of OAB symptoms an high percentage of patients discontinue the cure after a brief period. Our attempt is to investigate whether the cost of solifenacin succinate may influence the long lasting regimen and patients' drug efficacy.


MATERIALS AND METHODS
70 consecutive women, with symptoms of OAB were enrolled in this randomized controlled study. In group A, all patients received solifenacin 5 mg by the urologist, without any cost; they were instructed to get the drug once daily for 4 months, differently, in group B, patients need to buy the drug which was administered as in the group A. Frequency, nocturia, incontinence, voided volume, were evaluated by a 3-day micturition diary. Overactive Bladder Questionnaire Short Form (OAB-qSF) was used to assess the impact of OAB symptoms on patients' quality of life (QoL). Urgency was assessed by patient's perception of intensity of urgency scale (PPIUS). Micturition-diary, OAB-qSF, PPIUS, were completed at baseline and after four months.


RESULTS
A greater number of patients discontinued solifenacin in the group B who need to buy the drug. We observed significant differences in groups A and B in relation to frequency, nocturia, urge incontinence and voided volume comparing the pre and post treatment symptoms. The patients' perceptions of intensity of urgency and the PGI-I scale showed a significant improvement greater in group A in respect with group B.


CONCLUSIONS
The cost of anticholinergic may be responsible for both early discontinuation of treatment and incomplete adherence to therapy with unsatisfactory results on symptoms and an incorrect assessment of the effectiveness of the drug by the urologist.