The economic costs of overactive bladder in Germany

Objective: To estimate the annual direct costs of overactive bladder (OAB) in Germany from a societal perspective. Methods: Direct costs were calculated based on prevalence figures and medical resource utilisation due to hospitalisation, office-based physician visits, visits to other health care professionals, medication, medical aids and devices, and nursing care. Results: A total of 6.48 million adults >= 40 yr of age in Germany are affected by OAB, and 2.18 million of these individuals experience incontinence. The annual incidence of comorbidities attributable to OAB is 310,000 for skin infections, 40,000 for falls, 12,000 for fractures, and 26,000 for depression (based on 2004 census data). Direct OAB-related costs per year are epsilon 3.98 billion, with epsilon 1.76 billion covered by statutory health insurance, epsilon 1.80 billion by nursing care insurance, and epsilon 0.41 billion by the patients. Nursing care accounts for epsilon 1.80 billion of total costs (45%), devices account for epsilon 0.68 billion (17%), physician visits account for epsilon 0.65 billion (16%), complications account for epsilon 0.75 billion (19%), and medication accounts for epsilon 0.08 billion (2%). Conclusion: OAB imposes a substantial economic burden on German health and nursing care, insurance, and on patients with OAB. Direct annual costs are comparable to those of other chronic diseases such as dementia or diabetes mellitus. (C) 2006 European Association of Urology. Published by Elsevier B.V. All rights reserved.