A cost density analysis of benign prostatic hyperplasia

Area of Science:

• Urology
• Health Economics

Background:

• Benign prostatic hyperplasia (BPH) is a common condition affecting aging men.
• Understanding the costs and utilization patterns of BPH care is crucial for healthcare management.

Purpose of the Study:

• To assess the frequency and cost of medical services for benign prostatic hyperplasia (BPH) in a large health maintenance organization.
• To analyze trends in BPH treatment modalities and their associated healthcare expenditures over a four-year period.

Main Methods:

• Retrospective analysis of healthcare utilization and cost data for approximately 165,000 health plan subscribers from 1991 to 1994.
• Identification of 3919 men diagnosed with BPH and analysis of their treatment pathways, including medication (terazosin, finasteride) and surgical interventions (prostatectomy).
• Estimation of care costs using Medicare reimbursement schedules and medication wholesale prices.

Main Results:

• The study identified 3919 men with BPH, with 18% receiving terazosin, 6% undergoing prostatectomy, and 1% receiving finasteride.
• Average annual BPH care costs ranged widely, with major cost components including hospital admissions (35%), terazosin (29%), and physician visits (19%).
• Prostatectomy rates decreased by 80%, while terazosin dispensing doubled, leading to an overall reduction in total BPH care costs from 1991 to 1994.

Conclusions:

• Shifting treatment patterns in benign prostatic hyperplasia care, characterized by decreased prostatectomy rates and increased use of medications like terazosin, contributed to a significant decline in overall healthcare costs.
• These findings underscore the economic impact of evolving therapeutic strategies for BPH and inform healthcare resource allocation.