Under what conditions is feedback microwave thermotherapy (ProstaLund Feedback Treatment) cost-effective in comparison with alpha-blockade in the treatment of benign prostatic hyperplasia and lower urinary tract symptoms?
OBJECTIVE
Lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) are a common condition in men, and their incidence increases with age. The objective of this study was to evaluate the potential cost-utility of microwave thermotherapy, specifically the ProstaLund Feedback Treatment (PLFT), versus alpha-blockade in Swedish patients with LUTS due to BPH.


METHODS
A health-economic simulation model, based on long-term disease progression and costs, was developed to analyse the cost-utility of PLFT in comparison with alpha-blockade over a 3-year period based on data from published literature, treatment programmes and official price lists. Outcome measures used in the analysis were quality of life, survival and reduction in International Prostate Symptom Score. Sensitivity analyses were performed for a number of essential variables. The perspective of the study is the healthcare sector. All costs are expressed as 2003 prices.


RESULTS
Three years after an intervention with PLFT or initiation of drug treatment the cost-utility of PLFT was estimated at approximately euro 6600-9500 per quality-adjusted life-year gained. The cost-utility was further improved over a longer time period, and PLFT appears to be cost-saving after 5 years. One important finding from the model simulation was that PLFT also seems to be favourable in patients with less pronounced symptoms. This result may be further validated when additional results from controlled clinical trials become available.


CONCLUSIONS
The present model simulation indicates that treatment with PLFT seems to be cost-effective compared with drug therapy with alpha-blockade. The result shows that the time-frame of the analysis has a great impact on the cost-effectiveness ratio.
Ragnarson Tennvall
Gunnel
G
IHE, the Swedish Institute for Health Economics, Lund, Sweden. grt@ihe.se
Hjelmgren
Jonas
J
Malmberg
Lars
L
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D001676:Biofeedback, Psychology; D003362:Cost-Benefit Analysis; D006801:Humans; D006979:Hyperthermia, Induced / Q000191:economics*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D018803:Models, Economic; D011470:Prostatic Hyperplasia / Q000188:drug therapy / Q000628:therapy*; D011788:Quality of Life; D013548:Sweden; D014570:Urologic Diseases / Q000188:drug therapy / Q000628:therapy*
D000317:Adrenergic alpha-Antagonists