Overactive bladder in female patients over 60 years old: Therapeutical alternatives for a cost-effectiveness analysis in Brazil

Introduction. Considering the problem under analysis vis-à-vis the need for efficient resource allocation, the study takes into account the most workable therapeutical alternatives in the Brazilian context. Methods and materials. A study in this area of knowledge requires a sequence of steps. This is a study that has as its premise a synthesis of knowledges. Data bases consulted were: MedLine, Scielo, Cochranne, IBGE (Brazilian Geography and Statistics Institute) and DATASUS (Information System of the Sistema Único de Saúde - Unified Health System).Key words used, according to the different steps, were: health economic assessment, health economic evaluation, cost-effectiveness, methodology, guidelines, approach, framework, urinary incontinence, overactive bladder, prevalence, population based study, community-dwelling, overactive bladder management, efficacy, effectiveness and adverse effect. Results. Overactive Bladder (OB) is a clinical condition characterized by urinary symptoms: increase in urine frequency, nocturia and urinary urgency – which may or not present urgency incontinence.The only Brazilian study published on the problem was the one done by the Foundation of the Porto Alegre Federal Medical Sciences School, where overactive bladder prevalence is estimated at 18,9%. The estimated number of women possibly afflicted with Overactive Bladder in Brazil is 1.428.236 for the year 2008.Therapeutical alternatives are: oxibutinine, tolterodine, darafenacina, electrostimulation, cinesiotherapy, biofeedback, combined therapy, neuromodulation and botulin.DATASUS, even in its new presentation is not sufficient for the appraisal of used procedures related to the syndrome and its main associated morbid conditions (depression, urinary infection and others).Conclusion. In view of the syntheses made for each step involving the selection of alternatives for a cost-effectiveness analysis (CEA), considering the Government’s point of view, the search for resource allocation efficacy and the perspective of improving patients’ life quality, this research a priori directed its choice of a CEA appraisal of overactive bladder treatment to the following alternatives: electrostimulation and tolterodine LA (4 mg).