A cost comparison of medical management and transurethral needle ablation for treatment of benign prostatic hyperplasia during a 5-year period.
OBJECTIVE
We performed an analysis comparing the cost of medical management with TUNA therapy for a 5-year period.


METHODS
Published costs for tamsulosin, finasteride, transurethral needle ablation (TUNA, Medtronic, Inc., Minneapolis, Minnesota) and transurethral resection of the prostate were used to construct a cost analysis model comparing medication with TUNA. The model analyzed monotherapy with an alpha-blocker (tamsulosin) and a 5alpha-reductase inhibitor (finasteride), combination therapy using both medications, and a mixed scenario using monotherapy and combination therapy. Published data were used to estimate the rate of surgical intervention in patients initially treated with medications or TUNA.


RESULTS
Tamsulosin monotherapy was less expensive than TUNA for 5 years ($3,485 for tamsulosin vs $4,811 for TUNA year 5). Finasteride monotherapy reaches a break-even point with TUNA during year 5 ($4,867 for finasteride vs $4,811 for TUNA). Combination therapy reaches a break-even point with TUNA after approximately 2 years 7 months of treatment ($4,515 for combination therapy vs $4,572 for TUNA) and the mixed scenario breaks even with TUNA at approximately year 4 ($4,696 for medical management vs $4,645 for TUNA).


CONCLUSIONS
The TUNA procedure compares favorably to combination medical therapy for the treatment of benign prostatic hyperplasia on a cost basis. alpha-Blocker monotherapy is less costly than TUNA while 5alpha-reductase inhibitor monotherapy is approximately equivalent to TUNA for 5 years. The TUNA procedure is less expensive than combination medical management for 5 years, with a break-even point at approximately 2 years 7 months.
Naslund
M J
MJ
Division of Urology, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA. mnaslund@smail.umaryland.edu
Carlson
A M
AM
Williams
M J
MJ
D000368:Aged; D003131:Combined Modality Therapy / Q000191:economics; D003365:Costs and Cost Analysis; D003558:Cystoscopy / Q000191:economics*; D016527:Drug Costs / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D018120:Finasteride / Q000191:economics* / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015442:Medicare Assignment / Q000191:economics*; D008875:Middle Aged; D018803:Models, Economic; D011470:Prostatic Hyperplasia / Q000191:economics* / Q000628:therapy*; D019233:Retreatment / Q000191:economics; D013449:Sulfonamides / Q000191:economics* / Q000627:therapeutic use*; D000077409:Tamsulosin; D020728:Transurethral Resection of Prostate / Q000191:economics*; D016896:Treatment Outcome; D014481:United States
D013449:Sulfonamides; D018120:Finasteride; D000077409:Tamsulosin