Findings demonstrate an increased cost associated with bridging therapy with intravesical botulinum toxin type A (BTX-A) for a typical index pediatric patient with neurogenic detrusor overactivity, when compared to immediate augmentation cystoplasty (AC) over a ten-year span.

• A cost analysis from the payer perspective was conducted by computationally modeling treatment sequences by a Markov model, to compare the projected 10-year costs of AC vs BTX-A.

• For immediate AC, projected median and mean 10-year costs were $51,798.72 (95% CI [$51,798.72, $327,483.80]) and $123,473.4 (SD: $98,085.23) respectfully.

• For bridging therapy with BTX-A prior to proceeding to AC as required, projected median and mean 10-year costs were $74,552.46 (95% CI [$53,188.56, $309,913.07]) and $124,858.80 (SD: $84,495.35).