Cost Comparison of Benign Prostatic Hyperplasia Treatment Options

2019 ◽  
Vol 20 (8) ◽  
Author(s):  
Molly E. DeWitt-Foy ◽  
Bradley C. Gill ◽  
James C. Ulchaker
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Treatment Options ◽  
Prostatic Hyperplasia ◽  
Cost Comparison

scholarly journals Cost analysis of fixed-dose combination of dutasteride and tamsulosin compared with concomitant dutasteride and tamsulosin monotherapy in patients with benign prostatic hyperplasia in Canada

2014 ◽  
Vol 8 (1-2) ◽  
pp. 1 ◽  
Author(s):  
Amyn P. Sayani ◽  
Afisi S. Ismaila ◽  
Anna Walker ◽  
John Posnett ◽  
Bruno Laroche ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Lifetime Cost ◽  
Treatment Options ◽  
Prostatic Hyperplasia ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Effective Treatment Option ◽  
Health States ◽  
Cost Effective Treatment ◽  
Dose Combination

Introduction: We estimate the lifetime cost of treatment for moderate/severe symptoms associated with benign prostatic hyperplasia (BPH) in a cohort of Canadian men aged 50 to 59, and we evaluate the costs of 2 daily bioequivalent treatment options: fixed-dose combination (FDC) of dutasteride (0.5 mg) and tamsulosin (0.4 mg), or concomitant administration of dutasteride (0.5 mg) and tamsulosin (0.4 mg) monotherapies.Methods: The expected lifetime costs were estimated by modelling the incidence of acute urinary retention (AUR), BPH-related surgery and clinical progression over a patient’s lifetime (up to 25 years). A model was developed to simulate clinical events over time, based on a discrete Markov process with 6 mutually exclusive health states and annual cycle length.Results: The estimated lifetime budget cost for the cohort of 374 110 men aged 50 to 59 in Canada is between $6.35 billion and $7.60 billion, equivalent to between $16 979 and $20 315 per patient with moderate/severe symptoms associated with BPH. Costs are lower for FDC treatment, with the net difference in lifetime budget impact between the 2 treatment regimens at $1.25 billion. In this analysis, the true costs of BPH in Canada are underestimated for 2 main reasons: (1) to make the analysis tractable, it is restricted to a cohort aged 50 to 59, whereas BPH can affect all men; and (2) a closed cohort approach does not include the costs of new (incident) cases.Conclusion: Canadian clinical guidelines recommend the use of the combination of tamsulosin and dutasteride for men with moderate/severe symptoms associated with BPH and enlarged prostate volume. This analysis, using a representational patient group, suggests that the FDC is a more cost-effective treatment option for BPH. 

scholarly journals High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254143
Author(s):  
Maria M. Wertli ◽  
Brigitta Zumbrunn ◽  
Pascal Weber ◽  
Alan G. Haynes ◽  
Radoslaw Panczak ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Socioeconomic Factors ◽  
Regional Variation ◽  
Disease Burden ◽  
Treatment Options ◽  
Population Based ◽  
Prostatic Hyperplasia ◽  
Multilevel Regression ◽  
Discharge Data ◽  
Swiss German

Background Among various treatment options for benign prostatic hyperplasia (BPH), surgical therapy is the most invasive. As Switzerland has the highest transurethral prostatectomy rate among OECD countries, we assessed the regional variation in prostate surgery for BPH and explored potential determinants of variation. Methods We conducted a population-based analysis using discharge data for men aged ≥40 years with transurethral or simple prostatectomy from all Swiss hospitals during 2013–2018. After excluding patients with genitourinary/prostate cancer, we derived hospital service areas (HSAs) by analyzing patient flows. We calculated age-standardized mean procedure rates and variation indices (extremal quotient [EQ] and systematic component of variation [SCV]). We estimated the reduction in variance across HSAs of prostatectomy rates in multilevel regression models, with incremental adjustment for age, regional cultural and socioeconomic factors, disease burden, density of urologists, and the time since urologists’ graduation. Results Overall, 44,253 prostatectomies (42,710 transurethral and 1543 simple) from 44 HSAs were analyzed. The mean age-standardized prostate surgery rate was 314 (range 166–500) per 100,000 men aged ≥40 years per year. The EQ was 3.01 and the SCV 5.53, indicating a high regional variation. In multivariate models, men aged 75–79 years had an 11.6-fold higher prostatectomy rate than those aged 50–54 years. French/Italian language areas had a 21% lower rate than Swiss German speaking areas. Socioeconomic factors, disease burden, and density of urologist/time since graduation were not associated with prostatectomy rates. After full adjustment, 80% of the variance in prostate surgery across HSAs remained unexplained. Conclusion We found a remarkably high regional variation in prostate surgery rates for BPH within Switzerland.

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