With the ubiquity of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH) in older men, costs related to this highly prevalent disease are likely significant but not well defined. With this study, we hoped to define costs related to LUTS/BPH care.
We utilized the Optum© de-identified Clinformatics® Data Mart Database (CDM) for privately insured male enrollees aged 40-64 years with LUTS/BPH (N ≈ 100,300 annually) and the Centers for Medicare and Medicaid Services Medicare 5% Sample for male beneficiaries aged 65 + years with LUTS/BPH (N ≈ 147,800 annually). Annual LUTS/BPH-related expenditures from 2004 to 2013 were age standardized and calculated overall and by age and service location.
The Medicare cohort demonstrated a 23% increase in total costs over the study period with a 28% decrease in CDM costs. Decreases in inpatient hospital charges (45% for Medicare, 55% for CDM) were offset by increasing hospital-based outpatient fees (120% for Medicare, 87% for CDM). Overall, we estimated a total cost of at least $1.9 billion for treatment of men with LUTS/BPH for 2013. Per person expenditures increased with age within cohorts with an average per-person cost of $269 (CDM) and $248 (Medicare) in 2013.
The distribution of healthcare expenditures for LUTS/BPH shifted across practice settings from 2004 to 2013, with increasing outpatient relative to inpatient expenditures. Total direct costs for LUTS/BPH in 2013 were at least $1.9 billion, not accounting for indirect costs or certain unmeasured populations.
International urology and nephrology. 2022 Jul 29 [Epub ahead of print]
Charles Welliver, Lydia Feinstein, Julia B Ward, Ziya Kirkali, Erline Martinez-Miller, Brian R Matlaga, Kevin McVary, Urologic Diseases in America Project
Department of Urology, Albany Medical College, 23 Hackett Blvd, Albany, NY, 12208, USA. ., NociSci, Inc, Durham, NC, USA., National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA., Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA., Johns Hopkins University School of Medicine, Baltimore, MD, USA., Loyola University Medical Center, Center for Male Health, Maywood, IL, USA.