Tamsulosin is the most widely used alpha-1 blocker medication for managing benign prostatic hyperplasia (BPH) as indicated in the current practice guideline. The aim of this study was to compare all-cause medical costs and BPH-specific medical costs in older male adults with BPH treated with tamsulosin vs other alpha-1 blockers (i. e., doxazosin, terazosin, and alfuzosin).
This was a retrospective propensity-score matched cohort study based on 2006-2012 Medicare claims data. All-cause medical costs and BPH-specific medical costs were compared between tamsulosin and other alpha-1 blockers treatment groups using baseline-adjusted quantile regression analyses. The comparisons were performed at different percentiles of the cost distributions.
176,793 older male adults with BPH who used alpha-1 blockers were included in the analysis. All-cause medical costs in 75th and 95th percentiles of the cost distribution are substantially higher in tamsulosin treatment group when compared to other alpha-1 blocker medications (p < 0.05 for all). Tamsulosin treatment group had substantially higher BPH-specific medical costs in 99th percentile of the cost distribution when compared to doxazosin and terazosin (p < 0.001 for all). Overall, the top 5% of the patients with the highest all-cause medical costs accounted for approximately 45% of the overall all-cause medical costs, and the top 1% of the patients with the highest BPH-specific medical costs accounted for 39-51% of those costs.
Older adults with BPH who encountered higher medical expenses had substantially higher medical costs when treated with tamsulosin than other common alpha blockers. Cost-related quality of measures should be assessed to improve health outcomes in older adults with BPH.
Research in social & administrative pharmacy : RSAP. 2020 Sep 02 [Epub ahead of print]
Yulia Sidi, Yinghui Duan, Taeho Greg Rhee, Z Helen Wu
Department of Statistics, University of Connecticut, Storrs, CT, USA; Connecticut Convergence Institute of Translation in Regenerative Engineering, University of Connecticut, Farmington, CT, USA., Connecticut Convergence Institute of Translation in Regenerative Engineering, University of Connecticut, Farmington, CT, USA; Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA., Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA; Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA; Mental Illness Research, Education and Clinical Centers (MIRECC) of New England, VA Connecticut Healthcare System, West Haven, CT, USA., Connecticut Convergence Institute of Translation in Regenerative Engineering, University of Connecticut, Farmington, CT, USA; Department of Psychiatry, School of Medicine, University of Connecticut, Farmington, CT, USA. Electronic address: .