MP33-13 A PROSPECTIVE RANDOMIZED STUDY COMPARING THE SAFETY AND EFFICACY OF TRANSOBTURATOR TAPE (TOT) VERSUS TENSION FREE VAGINAL TAPE (TVT) IN TREATMENT OF FEMALE STRESS URINARY INCONTINENCE

decisions. The objective of this study is to estimate the direct medical and treatment costs of 4 OAB treatment options in patients inadequately managed on an anticholinergic. METHODS: A budget impact model was used to compare the annual costs of 4 OAB treatments: onabotA 100 U every 6 months, tolterodine 4mg long-acting anticholinergic (TOLT) once daily, MIR 50mg once daily, and SNM device. OnabotA costs included bladder injection and procedure costs; bladder scans; follow-up physician visits; and costs associated with urinary tract infection (18%) and urinary retention (6%) adverse events. MIR and TOLT costs included drug costs and follow-up physician visits. It was assumed that 16% of patients receiving MIR had uncontrolled hypertension requiring an additional physician visit. SNM costs included device eligibility testing and implantation, device maintenance costs, and battery replacement costs at year 7. Drug costs were estimated using 2013 wholesale average costs. 2013 Medicare reimbursement rates were used for all other costs, adjusted to commercial rates (122% of Medicare costs). RESULTS: The results of the cost analysis indicate that onabotA was the least costly OAB therapy during year 1 ($2,351), followed by TOLT ($2,626), MIR ($2,700), and SNM ($21,121) (see Table). The ranking order of treatment costs remained the same at years 5 and 10. CONCLUSIONS: This analysis suggests that onabotA is the least costly OAB treatment option in patients inadequately managed on an anticholinergic. The authors acknowledge that individual clinical data may drive the actual treatment pathway.