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Overactive Bladder Medication Costs Disproportionately Affect Ethnic Minorities

Thursday, October 5, 2023

4:20 PM – 4:24 PM US PST

Location: B113-116

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Image Label: Table 1. Racial Differences in OAB Symptoms, Work-Up, and Second-Line Therapy

Presenting Author(s)

Arshia Aalami Harandi, MD, MS (he/him/his)

Resident Physician
Stony Brook University Hospital
Stony Brook, New York, United States

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Co-Author(s)

Anjali Kapur, MD

Urogynecology Fellow
New York University
New York, New York, United States
JT

Justina Tam, MD

Attending Physician
Department of Urology, Stony Brook University Hospital
Stony Brook, New York, United States
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Jason Kim, MD

Attending Physician
Stony Brook University Hospital
Stony Brook, New York, United States

Disclosure(s):

Arshia Aalami Harandi, MD, MS: No financial relationships to disclose

Anjali Kapur, MD: No financial relationships to disclose

Justina Tam, MD: No financial relationships to disclose

Jason Kim, MD: AbbVIe: Consultant/Advisory Board (Ongoing); Axonics: Clinical Trial Investigator (Ongoing); Medtronic: Clinical Trial Investigator (Ongoing); Valencia Technologies: Consultant/Advisory Board (Ongoing)

Objectives: First- and second-line treatment of overactive bladder (OAB) are known to have high attrition rates. Approximately 70% of patients discontinue OAB medication at 6 months, and only 9% continue with medical management at 1 year. Furthermore, white patients are more likely to received advanced therapy for refractory OAB. This study aims to investigate whether there are racial disparities in the diagnosis and early treatment of OAB that may hinder therapy.

Methods: This was a cross-sectional study of adults with urinary incontinence recruited via SurveyMonkey with inclusion question, “Do you experience urine leakage?” Participants answered basic demographics questions, OAB symptoms questions, and questions about work-up, treatments offered, and reasons for quitting OAB treatment. These factors were analyzed by the patient’s self-reported race/ethnicity using the appropriate one-way ANOVA, Chi-square, or Fisher’s exact test. All analyses were conducted on SPSS version 28.0 with an alpha value of 0.05.

Results: Our sample (N=369) was self-identified female (100%) and predominantly Caucasian (69.6%) with representation of those identifying as African American (7.6%), Asian (6.8%), Hispanic (12.2%), and Other (3.8%). The mean age of our sample was 46.8 +/- 16 years, with Hispanic participants reporting significantly lower mean age than their Caucasian counterparts (40.0 vs. 50.1 years, p < .001). There were no significant differences in urinary symptoms, discussing symptoms with a doctor, or 2^nd line therapy use. However, racial and ethnic minorities were more likely to report not taking OAB medications due to cost than their white counterparts with Asian (36.0%), Hispanics (26.7%), and African Americans (25.0%) reporting the highest rates (p < .001).

Conclusions: Despite similar rates of OAB medication discontinuation rates and household income among the races represented in this study, racial and ethnic minorities reported higher rates of not taking OAB medication due to costs. This reveals a potential racial disparity in the treatment of OAB and further work is needed to deliver fair and equal treatment for all patients.