Medical therapy versus transurethral resection of the prostate (TURP) for the treatment of symptomatic benign prostatic enlargement (BPE): a cost minimisation analysis

PurposeA cost minimisation analysis comparesthe costs ofdifferent interventions' to ascertain the least expensive over time. We compared different prostate targeted drug treatments with TURP to identify the optimal cost saving duration of a medical therapy for symptomatic benign prostatic enlargement (BPE).MethodsThe Evolution registry is a prospective, multicentre registry, conducted by the European Association of Urology Research Foundation (EAUrf) for 24months in 5 European countries. Evolution was designed to register the management of symptomatic BPE in clinical practice settings in 5 European countries. Direct cost evaluation associated with prostate targeted medical therapies and TURP was also recorded and analysed.ResultsIn total, 1838 men were enrolled with 1246 evaluable at 24months. Medical therapies were more cost saving than TURP for treatment durations ranging from 2.9 to 70.4years. Cost saving depended on both medication class and individual country assessed. Daily tamsulosin monotherapy was more cost saving than TURP for13.9years in Germany compared to32.7years in Italy. Daily finasteride monotherapy was more cost saving for5.9years in France compared to36.9years in Spain. Combination therapy was more cost saving for5.9years for Italian patients versus13.8years in Germany.ConclusionsBPE medical management was more cost saving than TURP for different specific treatment durations. Information from this study will allow clinicians to convey medical and surgical costs over time, to both patients and payors alike, when considering BPE treatment.