Office-Based HE-TUMT Costs Less than Medication over Four Years in Treating Benign Prostatic Hyperplasia

Area of Science:

• Urology
• Medical Technology
• Health Economics

Background:

• Benign prostatic hyperplasia (BPH) is a common condition causing lower urinary tract symptoms (LUTS).
• Medications are the primary treatment for mild-moderate BPH, with minimally invasive therapies (MITs) also being viable early options.
• Direct comparisons between MITs and medications for BPH are limited, impacting treatment decisions.

Purpose of the Study:

• To compare the efficacy and cost-effectiveness of high-energy transurethral microwave therapy (HE-TUMT) against medical therapy for BPH.
• To evaluate differences in voiding symptoms, quality of life (QoL), and cumulative costs between HE-TUMT and medication arms.

Main Methods:

• A covariate-adjusted comparison of data from the Medical Therapy of Prostatic Symptoms (MTOPS) trial and pooled HE-TUMT data from seven independent studies.
• Analysis of voiding symptom and QoL improvements using repeated measure logistic regression.
• Cost analysis based on published outcomes, Medicare 2013 averages, and online pharmacy prices.

Main Results:

• HE-TUMT demonstrated significant improvements in voiding symptoms and QoL compared to MTOPS medication arms through the first two years.
• At four years, all treatment modalities showed comparable symptom improvements after adjusting for baseline covariates.
• Four-year cumulative costs for HE-TUMT were substantially lower ($3,620) than for combination medical therapy ($7,200).

Conclusions:

• HE-TUMT provides superior LUTS improvement over medication for the initial two years of BPH treatment.
• While all therapies yield comparable improvements at four years, HE-TUMT offers a less expensive option with better QoL outcomes.
• HE-TUMT represents a valuable alternative to medical therapy for BPH, warranting routine discussion and consideration in patient management.