Economic impact of surgical intervention in the treatment of benign prostatic hyperplasia

Abstract

The economic burden of benign prostatic hyperplasia (BPH) on our health care system is significant and likely to continue to grow given the burgeoning elderly population. Coincident with the rising number of annual physician office visits and expenditures for BPH has been a dramatic shift in the disease's management, from surgical to medical care. However, long-term cost data call into question the appropriateness of medical therapy as the initial treatment approach for all men with BPH, particularly those with moderate to severe symptoms. Although there has been a paradigm shift away from traditional BPH surgery, there has been renewed interest in the treatment of BPH with novel surgical techniques and minimally invasive surgeries. The economics of surgical interventions for BPH are discussed.

Figure 1

Likelihood of experiencing a significant event within 1 year, classified by diagnosis. CAD, coronary artery disease; GERD, gastroesophageal reflux disease. Reprinted with permission from Fenter TC et al.

Figure 2

Expected costs for each treatment for benign prostatic hyperplasia over time, based on 2004 costs and a 3% discount rate for a cohort of 1000 men aged 65 years. The plot assumes switching among pharmaceuticals and watchful waiting (WW). AB, α-blocker; ARI, 5α-reductase inhibitor; Combo, combination therapy; TUMT, transurethral microwave therapy; TURP, transurethral resection of the prostate. Reprinted with permission from DiSantostefano RL et al.