[Cost-effectiveness analysis of the treatment of moderate benign prostatic hyperplasia].
OBJECTIVE
To estimate the most cost-effective alternative of treatment of moderate benign prostatic hyperplasia and to learn whether the outcome can be varied by changing the cost or effectiveness of the alternatives.


METHODS
The study is made by a decision tree in order to test the cost-effectiveness (CE) rate of three treatment strategies: a) watchful waiting; if there is no response a drug is administered and if there is no response transurethral resection of the prostate (TURP) is done, b) pharmacological treatment, and if there is no response TURP is done, and c) to apply TURP initially. The treatment is simulated taking 1000 patients with MBPH and testing the outcome of events and probabilities in a two-year treatment and from the point of view of the health system as services supplier.


RESULTS
Effectiveness is obtained from an american experts' consensus. Only the direct fangible costs are taken into account, in constant 1998 pts. An univariant simple sensitivity analysis is made considering the cost variables of TURP and from the drugs in an acceptable range of +/- 20%, and the effectiveness of the watchful waiting and the pharmacological treatment. The lower cost alternative per improved patient (IP) is the watchful waiting (77,069 pts./IP) followed by the drug treatment (118,656 pts./IP) and lastly the TURP (456,642 pts./IP). Variations in the variable values make no difference in the relative positions of the tested alternatives.


CONCLUSIONS
From the pharmacoeconomics point of view the MBPH treatment must be iniciated by watchful waiting, proceeding to drug administration only if there is a positive response and to make use of TURP when the pharmacological procedures have not been effective.
Meseguer Barros
C M
CM
Servicio de Epidemiología, Consejería de Sanidad de la Comunidad de Madrid.
Fidalgo García
M L
ML
Rubio Cebrián
S
S
D003362:Cost-Benefit Analysis; D003663:Decision Trees; D017048:Health Care Costs; D006801:Humans; D008297:Male; D011470:Prostatic Hyperplasia / Q000191:economics* / Q000628:therapy*; D012720:Severity of Illness Index
Análisis coste-efectividad del tratamiento de la hiperplasia prostática benigna de grado moderado.