Economic Evaluation for Benign Prostatic Hyperplasia in Iran: Surgical Treatment or Dutasteride

AuthorJamaleddin Khedmatien
AuthorFatemeh Soleymanien
AuthorAsiye Moosivanden
AuthorSaman Zartaben
AuthorMeysam Seyedifaren
Issued Date2021-01-31en
AbstractBenign prostatic hyperplasia is a common chronic disease that is age-dependent. There are two main types of interventional treatment, transurethral resection of prostate as a gold standard (TURP) and open prostatectomy (OP); also, there are two pharmacological groups for managing BPH: alpha-blockers and 5-alpha-reductase inhibitors (5-ARIs). In this economic evaluation study, one 5-ARIs, dutasteride and two main surgical treatments are compared as alternatives for treating moderate BPH in Iran. A cost-utility study with an Iranian health provider perspective was conducted. Markov model in a cohort of 1000 patients with BPH with annual cycle length and ten years’ time horizon was developed by using MS EXCEL 2013. The effectiveness measure was an improvement in the IPSS score and transformed to the utility. The transition probabilities, utilities and adverse events were extracted from published clinical trials. The direct medical costs were measured in the 2017 US Dollar. One way sensitivity analysis and scenario analysis were conducted.For treating moderate BPH, seventy-year-old men, in the base case scenario, the utility of pharmacotherapy is 18 QALY less than surgery, and the cost of pharmacotherapy is 136,301.1 $ less than surgery. ICER for pharmacotherapy was 7,572.3 $ compared to surgery. In the sensitivity analysis, the model is not sensitive to most variables but the unit cost of dutasteride. Based on scenario analysis conducted for different age groups, pharmacotherapy with dutasteride is preferred to surgery in patients over 60 years of age in Iran. However, for younger adult men between 40-60 years old, surgery is a cost-effective alternative.en
DOIhttps://doi.org/10.22037/ijpr.2019.111979.13465en
KeywordCost-utility analysisen
KeywordDutasterideen
KeywordIranen
KeywordProstatectomyen
KeywordProstatic hyperplasiaen
PublisherBrieflandsen
TitleEconomic Evaluation for Benign Prostatic Hyperplasia in Iran: Surgical Treatment or Dutasterideen
TypeOriginal Articleen

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
ijpr-20-206.pdf
Size:
366.17 KB
Format:
Adobe Portable Document Format
Description:
Article/s PDF