Introduction: Vibegron was approved by the United States Food and Drug Administration in December 2020 for the treatment of overactive bladder (OAB). While beta-3 agonists may offer a more desirable side effect profile than anticholinergic medications, they are often more costly. The objective of this study is to report the early experience of a single institution prescribing Vibegron by describing its associated time burden of prior authorizations (PA) to the provider and cost to the patient. Methods: An institutional review board-approved retrospective review was performed for all patients prescribed vibegron by a single urologist from March 2021 to October 2022. Data was collected on patient demographics and insurance type, necessity for and time spent on PA by the provider, and patient cost for vibegron. Whether or not the patient filled the prescription given the out-of-pocket costs was also recorded. Wilcoxon Rank Sum and Chi Square statistical tests were used for analysis. Results: A total of 86 patients were included with a median age of 72 (IQR 58,78). 69% of patients required a PA with a median time required of 25 minutes (IQR 20,30). Ten patients needing prior authorizations were denied coverage for medication, three had a successful appeal for coverage. The median price to patients requiring a PA for a 30 day supply of Vibegron was $20 (IQR 0,122). The median price to patients not requiring a PA was $40 (IQR 7,116.5). The majority of patients had Medicare (37, 43.5%). 62.2% of Fee-for-Service (FFS) Medicare beneficiaries required a prior authorization, compared to 66.7% Medicaid, 79.2% private insurance and 66.7% for Medicare Advantage. There was no significant difference in the need for PA between the insurance types (p=0.3). Highest cost was noted with Medicare FFS ($100, IQR 4, 168). For patients (N=19, 22.4%) with no out-of-pocket costs for vibegron, 79% (15) required a PA with median time of 22.5 minutes. Only 31 patients (36.5%) confirmed to have filled their prescription. Conclusions: Vibegron can be both expensive to obtain for patients and time-consuming to prescribe for providers. Furthermore, in our cohort only one third of patients went on to fill their prescription. While limited by a small sample size, our study provided data regarding real world experience prescribing a new, yet at times costly drug. Further studies on patient satisfaction of Vibegron, continued prescribing patterns of Vibegron and associated burden on providers are needed to best understand this shared experience moving forward. SOURCE OF Funding: None
