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Economic analysis of finasteride: a model-based approach using data from the Proscar Long-Term Efficacy and Safety
P C Albertsen1, J M Pellissier, F C Lowe
1University of Connecticut Health Center, Farmington, USA.
Clinical Therapeutics
|August 10, 1999
Summary
Finasteride treatment for benign prostatic hyperplasia (BPH) reduces acute urinary retention and surgery risks. Economic analysis shows finasteride offers cost savings compared to watchful waiting and terazosin, especially for men with higher PSA levels.
Area of Science:
- Urology
- Health Economics
- Pharmacoeconomics
Background:
- Benign prostatic hyperplasia (BPH) is a common condition in older men, impacting quality of life and potentially leading to acute urinary retention (AUR) or necessitating surgery.
- The Proscar Long-Term Efficacy and Safety Study (PLESS) demonstrated finasteride's efficacy in reducing AUR and BPH-related surgery risks.
Purpose of the Study:
- To evaluate the economic implications of finasteride therapy for BPH compared to watchful waiting and alpha-blocker therapy (terazosin).
- To assess the cost-effectiveness of finasteride based on patient characteristics, including prostate-specific antigen (PSA) levels.
Main Methods:
- A model-based decision-analytic approach was used to compare treatment strategies.
- Data from the PLESS trial and published controlled data on terazosin were utilized for modeling.
- The base case involved a 64-year-old male with moderate-to-severe BPH symptoms.
Main Results:
- Finasteride demonstrated cost offsets compared to watchful waiting, with significant savings on surgical and AUR costs in the first year.
- Over 2 years, finasteride ($2304) was comparable in cost to terazosin ($2334).
- Finasteride showed greater cost-effectiveness in patients with higher PSA levels (≥1.4 ng/mL and ≥3.3 ng/mL), with savings of $373 over 2 years for the latter group.
Conclusions:
- Finasteride therapy presents economic advantages over watchful waiting and demonstrates cost savings compared to terazosin over a 2-year period.
- The cost-effectiveness of finasteride is enhanced in men with higher baseline PSA levels.
- These findings support finasteride as an economical treatment option for BPH, particularly in specific patient subgroups.
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