Economic aspects of treating benign prostatic hyperplasia

Nowadays, there are about 12 millions of men with prostatic hyperplasia; in terms of its incidence in the urological practice, this disease has the second place (23%), the most prevalent are the urinary tract diseases (32%). A blooming market of healthcare services aimed at treating benign prostatic hyperplasia (BPH) is now becoming available in Russia and worldwide. The number of comprehensive comparative studies on different methods of adenoma treatment from the perspective of clinical and economical effectiveness is growing from 90s. Nowadays, the studies of economical effectiveness of BPH treatment demonstrate that combined therapy makes more sense from the economical point of view in patients, whose PSA level is more than 3.2 ng/ml, in comparison with patients with PSA level varying from 1.3 to 3.2 ng/ml. As a general rule, financial studies and recommendations are done considering the situation in Europe, where old people are more wealthy and are not likely to have to pay for their treatment on their own. Due to this reason, Russian doctors have to discuss the financial aspects of treatment with their patients more thoroughly. For example, the financial expenses for using generics (Penester and Fokusin) during 10 years are more than twofold less expensive than using the original drugs (Omnic Okas and Avodart): 110 520 RUB versus 263 640 RUB. From our point of view, it can be seen that drug treatment of prostate cancer is more cost-effective, in comparison with transurethral resection of the prostate (TURP), but only during the period of 2-4 years. As for TURP, it is more cost-effective for long periods, due to the growth of costs of drugs. As for the minimally invasive approaches, they are not as pricy as TURP, but are less effective. As seen from the results of 20-year monitoring of different methods of treatment, TURP or microwave therapy are more expensive for the 5-year therapy, in comparison with the combined therapy. As for the long-term combined therapy (13 years), this way of treatment becomes the most expensive.