Cost effectiveness in the management of benign prostatic hyperplasia: Italian data

Several works in literature demonstrate that in some countries the economic considerations are as important as the clinical aspects of a disease; economic evaluation may be of help for decision making. The exact cost of the diagnosis and treatment of benign prostatic hypertrophy (BPH) patients is difficult to estimate. The total number of males in Italy is 27,982,144 (1991 data). In the last year 2,200,000 patients have been treated for BPH in Italy (surgically and pharmacologically); the overall cost for the therapy of BPH exceeded 46 million dollars per year. Currently surgery represents the standard treatment of BPH. In the USA alone over 350,000 surgical procedures are performed annually. In USA the cost per TURP is 12,000 dollars. In Italy the minimum direct cost is 3681 dollars; in most cases, however, the cost per TURP is over 5000 dollars. It is estimated that about 80% of patients with micturition problems prefer an alternative treatment before surgery. In our country 4,338,000 diagnoses of BPH have been performed in 1991. The number of prescriptions for BPH has been 4,867,000 and the number of drugs per prescription 1.16. It may be of interest to compare costs associated with different pharmacological therapies for BPH. Considering the direct costs, it has been estimated that the cost of 1 year's treatment with finasteride is 1833 dollars, while that of 1 year with plant extracts is 1151 dollars. The existing literature is deficient in defining the cost related to the therapeutical options for BPH. On the contrary, economic considerations must be included in each clinical research. Such informations, balancing costs and benefits, are crucial and may influence strategies for management of BPH.