1 Recommendations

1.1

Vibegron is recommended as an option for treating the symptoms of overactive bladder syndrome in adults. It is only recommended if antimuscarinic medicines are not suitable, do not work well enough or have unacceptable side effects.

1.2

If people with the condition and their healthcare professional consider vibegron to be 1 of a range of suitable treatments, after discussing the advantages and disadvantages of all the options, the least expensive should be used. Administration costs, dosages, price per dose and commercial arrangements should all be taken into account.

1.3

This recommendation is not intended to affect treatment with vibegron that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop.

Why these recommendations were made

Usual treatment for symptoms of overactive bladder syndrome is antimuscarinic medicines. If these are not suitable, do not work well enough or have unacceptable side effects, mirabegron is recommended as a treatment option. Vibegron works in a similar way to mirabegron. This evaluation only looked at vibegron for the same people who would be offered mirabegron.

Clinical trial evidence shows that vibegron is more effective than placebo for treating the symptoms of overactive bladder syndrome. The evidence is limited because most people in the trial had not had antimuscarinic medicines. But the reduction in symptoms was similar for people who had had antimuscarinic medicines and people who had not. The licensed dose of vibegron (75 mg) has not been directly compared in a clinical trial with mirabegron, but an indirect treatment comparison suggests it is likely to work as well.

Cost-comparison results suggest vibegron is likely to be cost saving compared with mirabegron. So, vibegron is recommended.

For all evidence see the committee papers. For more information on NICE's evaluation of mirabegron, see the committee discussion section in NICE's technology appraisal guidance on mirabegron for treating symptoms of overactive bladder.