The economic impact of using alfuzosin 10 mg once daily in the management of acute urinary retention in the UK: a 6-month analysis.
OBJECTIVE
To calculate the economic consequences of using alfuzosin 10 mg once daily for managing acute urinary retention (AUR) related to benign prostatic hyperplasia (BPH).


METHODS
We examined whether alfuzosin use during hospitalization for AUR and for 6 months after a successful trial without catheter (TWOC) is cost effective compared to placebo and immediate prostatectomy, from the perspective of patients managed in the National Health Service (NHS) in the UK. A decision-analysis model was developed to estimate the costs of various treatment options within the first 6 months after a first episode of AUR. Clinical data were obtained from a large randomized clinical trial comparing alfuzosin 10 mg with placebo, and from published reports. Cost data were obtained from both NHS and resource-use data gathered during the clinical trial. A Monte Carlo analysis, allowing variability in all uncertain variables of the model, was used to calculate the uncertainty surrounding the results.


RESULTS
Treating patients with alfuzosin during initial hospitalization for AUR and in the first 6 months after a successful TWOC generates a cost-saving of pounds 349 relative to placebo. Savings related to immediate prostatectomy were pounds 892; both savings were significant (P < 0.05). Alfuzosin treatment was associated with a lower rate of prostatectomy after discharge from hospital after a successful TWOC.


CONCLUSIONS
Treatment with alfuzosin 10 mg once daily before and after a successful TWOC has both clinical and economic benefits. It decreases the need for emergency surgery for BPH and reduces treatment costs in the first 6 months.
Annemans
Lieven
L
Department of Public Health, Ghent University, Ghent, Belgium. LAnnemans@be.imshealth.com
Cleemput
Irina
I
Lamotte
Mark
M
McNeill
Alan
A
Hargreave
Timothy
T
D000317:Adrenergic alpha-Antagonists / Q000191:economics* / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D003661:Decision Support Techniques; D016527:Drug Costs; D004638:Emergency Treatment / Q000191:economics; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009010:Monte Carlo Method; D011468:Prostatectomy / Q000191:economics; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery; D011799:Quinazolines / Q000191:economics* / Q000627:therapeutic use*; D006113:United Kingdom; D016055:Urinary Retention / Q000188:drug therapy* / Q000191:economics / Q000209:etiology
D000317:Adrenergic alpha-Antagonists; D011799:Quinazolines; C047638:alfuzosin