Skip to main content

Advertisement

SpringerLink
Log in

Cost Comparison of Benign Prostatic Hyperplasia Treatment Options

  • Benign Prostatic Hyperplasia (K McVary, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To provide an economic context within which to consider treatment options for benign prostatic hyperplasia (BPH). To this end, this review provides a comparison of the costs of combination medical therapy, operative treatment, and office-based therapies for BPH from a payer perspective.

Recent Findings

Analysis of Medicare charges from the authors’ institution, as well as local retail costs of medication, demonstrated a wide range in costs of commonly used BPH treatments. In this study, interventions for BPH reached cost equivalence with combination medical therapy within 6 months to 8 years.

Summary

A myriad of options for managing men with symptomatic BPH exist. It is prudent not only to consider surgeon preference and patient-specific factors when selecting a treatment but also to understand the economic impact different BPH therapies confer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. Herr HW. The enlarged prostate: a brief history of its surgical treatment. BJUI. 2006;98(5):947–52.

    Article  Google Scholar 

  2. Napalkov P, Maisonneuve P, Boyle P. Worldwide patterns of prevalence and mortality from benign prostatic hyperplasia. Urology. 1995;46:41–6.

    Article  CAS  Google Scholar 

  3. Xu PJ, Barnes JM, Choe EM, Syed JR, Siddiqui SA. Variability of retail pricing of generic urologic medications in a major US metropolitan area. Urology. 2019;125:29–33.

    Article  Google Scholar 

  4. Messina R, Mirone V. Benign prostatic hyperplasia—an economic assessment of fixed combination therapy based on a literature review. Arch Ital di Urol Androl organo Uff [di] Soc Ital di Ecogr Urol e Nefrol. 2015;87:185–9.

    Article  CAS  Google Scholar 

  5. Gravas S, Oelke M. Current status of 5alpha-reductase inhibitors in the management of lower urinary tract symptoms and BPH. World J Urol. 2010;28(1):9–15.

    Article  CAS  Google Scholar 

  6. McConnell JD, Roehrborn CG, Bautista OM, Andriole GL Jr, Dixon CM, Kusek JW, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. NEJM. 2003;349:2387–98.

    Article  CAS  Google Scholar 

  7. Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Nandy I, et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol. 2010;57(1):123–31.

    Article  CAS  Google Scholar 

  8. Kaplan SA, et al. Time course of incident adverse experiences associated with doxazosin, finasteride and combination therapy in men with benign prostatic hyperplasia: the MTOPS trial. J Urol. 2016;195(6):182.

    Google Scholar 

  9. Foster HE, Barry MJ, Dahm P, Gahndi MC, Kaplan SA, Kohler TS, et al. Surgical management of lower urinary tract symptoms attributed to benign prostatichyperplasia: AUA Guideline. J Urol. 2018;200(3):612–9.

  10. Varda BK, Wang Y, Chung BI, Lee RS, Kurtz MP, Nelson CP, et al. Has the robot caught up? National trends in utilization, preoperative outcomes, and cost for open, laparoscopic, and robotic pediatric pyeloplasty in the United States from 2003 to 2015. J Pediatr Urol. 2018;14(4):336.e1–8.

    Article  Google Scholar 

  11. •• Kaplan AL, et al. Measuring the cost of care in benign prostatic hyperplasia using time-driven activity-based costing (TDABC). Healthcare. 2015;3(1):43–8. Use of time-driven activity-based costing to compare costs associated with five different surgical options for BPH treatment.

    Article  CAS  Google Scholar 

  12. Masucci L, et al. Cost analysis of Greenlight photoselective vaporization of the prostate compared to transurethral resection of the prostate for benign prostatic hyperplasia. Can Urol Assoc J. 2018;12(12):382–7.

    Article  Google Scholar 

  13. Brown AD. Minimally invasive treatment for benign prostatic hyperplasia: economic evaluation from a standardized hospital case costing system. Cardiovasc Intervent Radiol. 2019;42(4):520–7.

    Article  Google Scholar 

  14. •• Ulchaker JC, Martinson MS. Cost-effectiveness analysis of six therapies for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Clinicoecon Outcomes Res. 2018;10:29–43. Cost-effectiveness analysis of six current BPH treatments from payers’ perspective, using IPSS scores, adverse events, and retreatment rates to estimate ICERs for pairs of treatments.

    Article  Google Scholar 

  15. Cockrell R, Lee DI. Robotic-assisted simple prostatectomy: expanding on an established operative approach. Curr Urol Rep. 2017;18:37.

    Article  Google Scholar 

  16. Sun F, Sun X, Shi Q, Zhai Y. Transurethral procedures in the treatment of benign prostatic hyperplasia. Medicine (Baltimore). 2018;97(51):e13360.

    Article  Google Scholar 

  17. •• Chung ASJ, Wood HH. Update on minimally invasive surgery and benign prostatic hyperplasia. Asian J Urol. 2018;5(1):22–7. Evaluation of novel minimally invasive surgical options through review of literature, with particular focus on studies published in the preceding five years.

  18. McVary KT, Rogers T, Roehrborn CG. Rezum water vapor thermal therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia: 4-year results from randomized controlled trials. Urology. 2019;126:171–9.

    Article  Google Scholar 

  19. Roehrborn CG, et al. Five year results of the prospective randomized controlled prostatic urethral L.I.F.T study. Can J Urol Int. 2017;24(3):8802–13.

    Google Scholar 

  20. Rukstalis D, Grier D, Stroup SP, Tutrone R, deSouza E, Freedman S, et al. Prostatic urethral lift (PUL) for obstructive median lobes: 12 months results of the MedLift study. Prostate Cancer Prostatic Dis. 2018. https://doi.org/10.1038/s41391-018-0118-x.

  21. •• Davis NF, et al. Medical therapy versus transurethral resection of the prostate (TURP) for the treatment of symptomatic benign prostatic enlargement (BPE): a cost minimisation analysis. World J Urol. 2018;37:873–8. https://doi.org/10.1007/s00345-018-2454-9. Use of a prospective, multicenter registry across Europe to evaluate the relative cost of BPH medical therapy and TURP.

    Article  PubMed  Google Scholar 

  22. Smith C, Craig P, Taleb S, Young S, Golzarian J. Comparison of traditional and emerging surgical therapies for lower urinary tract symptoms in men: a review. Cardiovasc Intervent Radiol. 2017;40:1176–84.

    Article  Google Scholar 

  23. Benejam-Gual JM, et al. Cost effectiveness analysis at 2 years of surgical treatment of benign prostatic hyperplasia by photoselective vaporization of the prostate with GreenLight-photo vaporization 120 W versus transurethral resection of the prostate. Actas Urol Esp. 2014;38(4):238–43.

    Article  CAS  Google Scholar 

  24. •• Gill BC, Ulchaker JC. Costs of managing benign prostatic hyperplasia in the office and operating room. Curr Urol Rep. 2018;19(9):72. Review of the relative costs of BPH therapy including medical therapy, operating room based surgical therapy and office-based procedures from the payers’ perspective.

  25. Erman A, Masucci L, Krahn MD, Elterman DS. Pharmacotherapy vs surgery as initial therapy for patients with moderate-to-severe benign prostate hyperplasia: a cost-effective analysis. BJU Int. 2018;122(5):879–88.

    Article  Google Scholar 

  26. Egan KB. The epidemiology of benign prostatic hyperplasia associated with lower urinary tract symptoms. Urol Clin North Am. 2016;43(3):289–97.

    Article  Google Scholar 

  27. Taub DA, Wei JT. The economics of benign prostatic hyperplasia and lower urinary tract symptoms in the United States. Curr Urol Rep. 2006;7(4):272–81.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Mail Stop Q10-1 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Molly E. DeWitt-Foy, Bradley C. Gill & James C. Ulchaker

  2. Lerner College of Medicine, Education Institute, Cleveland Clinic, Mail Stop NA21 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Molly E. DeWitt-Foy, Bradley C. Gill & James C. Ulchaker

  3. Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA

    Bradley C. Gill

Authors
  1. Molly E. DeWitt-Foy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bradley C. Gill
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James C. Ulchaker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Molly E. DeWitt-Foy.

Ethics declarations

Conflict of Interest

Molly E. DeWitt-Foy and Bradley C. Gill each declare no potential conflicts of interest.

James C. Ulchaker reports personal fees from Boston Scientific and Foretc Medical.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Benign Prostatic Hyperplasia

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

DeWitt-Foy, M.E., Gill, B.C. & Ulchaker, J.C. Cost Comparison of Benign Prostatic Hyperplasia Treatment Options. Curr Urol Rep 20, 45 (2019). https://doi.org/10.1007/s11934-019-0907-3

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11934-019-0907-3

Keywords

Search

Navigation