Harstall CM; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1995; 11: Abstract No. 202.
HTA Unit, Alberta Health, Edmonton, Canada.
OBJECTIVES: In October 1992, finasteride for the treatment of symptomatic benign prostatic hyperplasia (BPH), was approved by Health and Welfare Canada. Following this approval, the provincial drug formularies across Canada had to consider if this drug will be included or excluded as a benefit. The intent of this study was to provide the best available information on estimated costs of approved treatment outcomes and the estimated costs for BPH in Alberta to an advisory committee to assist them with the decision-making process. METHODS: The determinants for identifying the most appropriate group of BPH patients for this treatment were derived from a systematic literature review, including the AHCPR guideline, abstracts presented at the annual American Urological Association (AUA), and published and unpublished documents. Data elements were extracted from Alberta Health's claims and hospital morbidity data bases over six consecutive fiscal years beginning with 1987/88. Records were selected by diagnosis and specific fee code items and procedure codes and then sorted by age group. Expenditures and length of stay were age-specified. All expenditures were expressed in 1992/93 constant dollars. RESULTS: Etiology and natural history for BPH are not well understood. The AUA Symptom Index is the most commonly used instrument to objectively document a patient's symptom level. Patients tend to seek treatment based on the degree to which they are bothered by urinary symptoms. There is a range of treatment preference among patients. Patients with moderate to severe AUA symptoms scores may benefit from finasteride therapy. Variations in prostatectomies cannot be related to a specific determinant. Total number of prostatectomies is decreasing. Hospital expenditures are decreasing (excluding diagnostic expenditures) while physician expenditures remain fairly constant. Estimated provincial expenditures for BPH have decreased approximately 40% over the study period. Expenditures tend to increase with age. Appoximately 70% of physician services were provided by urologists. CONCLUSION: Provincial expenditures and surgical procedures for BPH began decreasing prior to the introduction of finasteride therapy. Provincial expenditures for patients with a diagnosis of BPH vary with age. Identification of the appropriate treatment group with finasteride relies on several factors.
Publication Types:
Keywords:
- Alberta
- Canada
- Costs and Cost Analysis
- Drug Therapy, Combination
- Finasteride
- Health Expenditures
- Humans
- Male
- Morbidity
- Prevalence
- Prostatectomy
- Prostatic Hyperplasia
- Treatment Outcome
- diagnosis
- drug therapy
- economics
- surgery
- therapy
- hsrmtgs
Other ID:
UI: 102215949
From Meeting Abstracts