Prostatic Hyperplasia
Conditions
Keywords
Benign prostatic hyperplasia, Adherence, Acute urinary retention, Enlarged prostate, 5-alpha reductase inhibitor, Surgery, Cost and cost analysis
Brief summary
Adherence and length of therapy with 5-alpha reductase inhibitor (5ARI) treatment may be associated with improved clinical outcomes of enlarged prostate (EP) as well as lower health care costs. The objective of this retrospective database analysis is to quantify the relationship between adherence and length of therapy with a 5ARI and the likelihood of acute urinary retention (AUR) or prostate surgery (emergency and non-emergency) in patients with benign prostatic hyperplasia (BPH). The study will also measure the economic impact associated with these medical encounters. The MarketScan database contains data from people with commercial health insurance and Medicare and includes both medical and pharmacy data that are sourced directly from health plans and employers. Approximately 18 million covered lives will be utilized for this study in the time period from January 1, 2003 to September 30, 2009. This study is a retrospective cohort analysis of medical claims data.
Interventions
DRUG5-alpha Reductase Inhibitor (5ARI)
A 5ARI: Either dutasteride or finisteride
Sponsors
GlaxoSmithKline
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
MALE
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male * Aged 50 years or older * A diagnostic claim of benign prostatic hyperplasia (International Classification of Diseases, Ninth Revision, Clinical Modification \[ICD-9-CM\] codes 222.2x or 600.xx) * A prescription claim for a 5-alpha reductase inhibitor (5ARI) for at least 60 days during the observation period * Continuous health plan eligibilitiy for 6 months prior to and at least 150 days after the initial 5ARI prescription
Exclusion criteria
* A diagnosis of prostate cancer (ICD-9-CM codes 185.xx, 198.82, 233.4, 236.5, 239.5, V10.46) * A diagnosis of bladder cancer (ICD-9-CM codes 188.xx, 198.1, 223.3, 233.7, 239.4, V10.51), * A procedure code for any prostate-related surgery prior to the index date or 150 days after the index date * A diagnosis code for acute urinary retention (AUR) prior to the index date or 150 days after the index date
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The occurence of a diagnosis code for acute urinary retention (AUR) or a procedure code for prostate surgery | One year following the first date of 5ARI therapy | The occurence of a code for either AUR or prostate surgery will be identified for patients who were adherent with 5ARI therapy as measured with a medication possession ratio (MPR) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean costs associated with AUR or prostate surgery | One year following the first date of 5ARI therapy | The mean costs of outpatient and inpatient visits associated with the diagnosis code for AUR or the procedure codes for prostate surgery will be compared between patients who were compliant with 5ARI therapy and those who were not |
Outcome results
None listed