Bradley C Gill1,2,3, James C Ulchaker4,5. 1. Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Mail Stop Q10-1 9500 Euclid Avenue, Cleveland, OH, 44195, USA. gillb@ccf.org. 2. Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, OH, USA. gillb@ccf.org. 3. Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. gillb@ccf.org. 4. Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Mail Stop Q10-1 9500 Euclid Avenue, Cleveland, OH, 44195, USA. 5. Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, OH, USA.
Abstract
PURPOSE OF REVIEW: To review the costs associated with benign prostatic hyperplasia (BPH) management. Specifically, to compare the costs of medical therapy, office-based procedures, and surgical management from a payer perspective. RECENT FINDINGS: The American Urological Association released updated guidelines in 2018 for the surgical management of BPH. Over recent years, analyses investigating the cost-effectiveness of the modalities included in these guidelines have been completed. These show relatively newer, minimally-invasive office-based therapies can provide cost-effective alternatives to medical therapy. Likewise, surgical therapies provide a cost-effective means of BPH management, if performed well with low complication rates. However, comparisons of these studies are limited by the biases they contain. Minimally-invasive office-based therapies and well performed surgical therapies for BPH can achieve cost equivalence to combination medical therapy within a few years. Factors such as age, gland size, patient compliance, and surgeon skill should be considered when personalizing treatment recommendations for each patient.
PURPOSE OF REVIEW: To review the costs associated with benign prostatic hyperplasia (BPH) management. Specifically, to compare the costs of medical therapy, office-based procedures, and surgical management from a payer perspective. RECENT FINDINGS: The American Urological Association released updated guidelines in 2018 for the surgical management of BPH. Over recent years, analyses investigating the cost-effectiveness of the modalities included in these guidelines have been completed. These show relatively newer, minimally-invasive office-based therapies can provide cost-effective alternatives to medical therapy. Likewise, surgical therapies provide a cost-effective means of BPH management, if performed well with low complication rates. However, comparisons of these studies are limited by the biases they contain. Minimally-invasive office-based therapies and well performed surgical therapies for BPH can achieve cost equivalence to combination medical therapy within a few years. Factors such as age, gland size, patient compliance, and surgeon skill should be considered when personalizing treatment recommendations for each patient.
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