Cost Analysis of Treatment Options for BPH (Enlarged Prostate)

A recent cost analysis of treatment options for BPH (benign prostatic hyperplasia) found that Rezum (a water vapor energy technology that delivers stem to the prostate and damages the offending cells) was the most cost effective of the six chosen items. The other treatments evaluated were

  • Combination drug therapy (use of dutasteride or finasteride plus tamsulosin or doxazosin
  • Prostiva (i.e., transurethral needle ablation [TUNA], which uses radio frequency to kill excess prostatic tissue)
  • UroLift (use of tiny implants to hold prostate away from the urethra)
  • Green Light (photoselective vaporization of the prostate utilizing laser)
  • TURP (transurethral resection of the prostate).

BPH is a prostate condition characterized by an enlarged prostate and urinary symptoms such as urinary frequency, urinary urgency, dribbling, stopping and starting when urinating, pain when urinating, and frequent need to urinate during the night. Clinicians and their patients have a wide variety of treatment options from which to choose to help relieve symptoms.

Related: Comparing treatments for enlarged prostate (BPH)

Cost and effectiveness are two major considerations when selecting a therapy. Currently, the cost of treating BPH in the United States is about $4 billion, and costs will likely rise as the population of older men continues to grow as well. Therefore, identifying cost-effective treatments for BPH is important.

Here are the results of the cost analysis, which was based on two years and looked at clinical improvements, retreatment rates, and side effects. The analysis was done using a computerized economic model and simulated patients.

  • Combination drug therapies were the least effective
  • Combination drug therapies that use branded drugs was the most expensive option ($7,082)
  • TURP and Green Light ($5,099) were slightly more effective at symptom relief when compared with Rezum, and both cost about twice as much as Rezum ($2,582)
  • UroLift and Rezum are similarly effective, but the former ($6,386) is more than twice that of the latter
  • All of the treatment options for BPH are associated with some side effects

Research has shown that the Rezum treatment approach provides good symptom relief and is not associated with erectile dysfunction, unlike surgical BPH therapies. Note that this study was supported by NxThera Inc, which makes the Rezum System.

References

Loeb S et al. Testosterone replacement therapy and risk of favorable and aggressive prostate cancer. Journal of Clinical Oncology 2017 May 1; 35(13): 1430-36

Ulchaker JC, Martinson MS. Cost-effectiveness analysis of six therapies for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. ClinicoEconomics and Outcomes Research 2017 Dec 29; 10: 29-43


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