Overactive bladder (OAB) is a common condition that increases in prevalence with age and has a significant negative impact on quality of life.

For the past 40 years, antimuscarinic agents have been the mainstay of therapy for OAB; however, unmet efficacy expectations and side effects, particularly dry mouth, limit persistence with antimuscarinic therapy.

Recently, an alternative to antimuscarinic agents has received marketing authorisation; the β3-adrenergic receptor agonist mirabegron is associated with at least similar efficacy to most antimuscarinic therapies and also has a lower incidence of dry mouth.

No economic analyses of mirabegron compared to antimuscarinic agents in the treatment of OAB have been performed; therefore, we developed a model to analyse the cost effectiveness of mirabegron 50 mg/day relative to currently available antimuscarinic agents for the treatment of OAB from a UK National Health Service perspective.

The model captured the effects of variations in symptom severity over time on quality of life and the influence of treatment discontinuation and switch on costs and health outcomes, as well as direct treatment costs.

Compared to tolterodine extended release 4 mg, mirabegron 50 mg was cost effective, with an approximately 90 % probability of cost effectiveness at a willingness-to-pay threshold of £20,000.