Propiverine is an anticholinergic used to treat overactive bladder, but it has almost no presence in the US, where it is not approved by the FDA or standard in clinical practice. Prescribers rely instead on oxybutynin, tolterodine, solifenacin, and the beta-3 agonists mirabegron and vibegron, which benefit from established brand recognition and strong payer coverage. US demand for overactive...