Cost-effectiveness of combination therapy for treatment of benign prostatic hyperplasia: a model based on the findings of the Combination of Avodart and Tamsulosin trial

摘要: Study Type – Therapy (cost effective analysis with multi-way sensitivity analysis) What's known on the subject? and What does study add? Little has been published whether benefits of combination therapy are worth additional expense a second prescription. This manuscript adds to literature by exploring cost effectiveness dutasteride tamsulosin compared alpha blocker 5ARI monotherapy. OBJECTIVE •  To evaluate cost-effectiveness for benign prostatic hyperplasia (BPH) alpha-blocker (AB), 5-alpha reductase inhibitor (5ARI) monotherapy or watchful waiting (WW) in male patients enrolled Combination Avodart Tamsulosin (CombAT) trial using Norwegian economic model. PATIENTS AND METHODS •  A decision analytic model was constructed BPH treatment regimens point estimate base-case analyses, one-way testing probabilistic analyses. •  Symptom severity acute urinary retention/transurethral resection prostate (AUR/TURP) event data came from 4-year evaluation CombAT Medical Prostatic Symptoms (MTOPS) trial. The makes use practice pattern unit utility estimates were taken literature. •  The calculates costs outcomes at two time horizons: 4 years lifetime. Incremental ratios (ICERs) calculated WW as basis comparison. Costs health state utilities discounted after first year. RESULTS •  At years, ICER results higher than AB result drug cost, but overall quality-adjusted life-year (QALY) differences small. •  At lifetime evaluation, decrease those horizon, although remains less expensive therapy. However, incremental QALYs gained twice monotherapy. CONCLUSIONS •  The is sensitive variability assigned symptom severity, indicating that both have an advantage maintaining severe states. •  Overall, expected provide greatest net monetary benefit willingness-to-pay thresholds above ≈€6000 (£5400).