Establishing the clinical and economic benefits of adherence to 5-alpha reductase inhibitors in benign prostatic hyperplasia: an assessment of Medicare and Medicaid patients

Abstract

Objective: The primary objective of this study was to evaluate the length of 5-alpha reductase inhibitor (5ARI) therapy on the likelihood of acute urinary retention (AUR) and prostate surgery in patients diagnosed with benign prostatic hyperplasia (BPH). Additionally, this study attempted to quantify the relationship between length of 5ARI therapy and monthly BPH-related medical costs.

Study design: This study used MarketScan® claims data from January 1, 2003, to December 31, 2008. Male Medicare patients ≥ 65 years and Medicaid patients ≥ 50 years who received a diagnosis of BPH and at least one claim for a 5ARI during the study period were included. Cox proportional hazards models were used to evaluate the effect of length of therapy on AUR and surgery, whereas generalized linear models were used to assess the effect on costs.

Results: In 28,903 patients, every additional 30 days of 5ARI therapy reduced the likelihood of AUR and prostate surgery by 14 and 11%, respectively, while each 30-day increment of 5ARI therapy reduced BPH-related costs by 15%.

Conclusion: For patients remaining on 5ARI therapy, significant clinical and economic benefits may be realized, including reductions in AUR and prostate surgery rates and reduced medical costs for these clinical events.

Keywords::

• 5-alpha reductase inhibitors
• adherence
• benign prostatic hyperplasia
• length of therapy
• Medicaid
• Medicare
• prostate

Acknowledgments

The authors acknowledge and thank E Zagadailov for her clinical expertise and assistance in writing this article.