Cost analysis of fixed-dose combination of dutasteride and tamsulosin compared with concomitant dutasteride and tamsulosin monotherapy in patients with benign prostatic hyperplasia in Canada

Authors

  • Amyn P. Sayani GlaxoSmithKline, Inc.
  • Afisi S. Ismaila GlaxoSmithKline, Inc.
  • Anna Walker Heron Evidence Development Ltd
  • John Posnett Heron Evidence Development Ltd
  • Bruno Laroche Laval University; Hôpital Saint-François d’Assise
  • J. Curtis Nickel Queen's University; Kingston General Hospital, Kingston, ON
  • Zhen Su GlaxoSmithKline, Inc.

DOI:

https://doi.org/10.5489/cuaj.755

Keywords:

Benign Prostatic Hyperplasia, cost analysis, Markov model, tamsulosin, dutasteride, Jalyn, Canada

Abstract

Introduction: We estimate the lifetime cost of treatment for moderate/severe symptoms associated with benign prostatic hyperplasia (BPH) in a cohort of Canadian men aged 50 to 59, and we evaluate the costs of 2 daily bioequivalent treatment options: fixed-dose combination (FDC) of dutasteride (0.5 mg) and tamsulosin (0.4 mg), or concomitant administration of dutasteride (0.5 mg) and tamsulosin (0.4 mg) monotherapies.

Methods: The expected lifetime costs were estimated by modelling the incidence of acute urinary retention (AUR), BPH-related surgery and clinical progression over a patient’s lifetime (up to 25 years). A model was developed to simulate clinical events over time, based on a discrete Markov process with 6 mutually exclusive health states and annual cycle length.

Results: The estimated lifetime budget cost for the cohort of 374 110 men aged 50 to 59 in Canada is between $6.35 billion and $7.60 billion, equivalent to between $16 979 and $20 315 per patient with moderate/severe symptoms associated with BPH. Costs are lower for FDC treatment, with the net difference in lifetime budget impact between the 2 treatment regimens at $1.25 billion. In this analysis, the true costs of BPH in Canada are underestimated for 2 main reasons: (1) to make the analysis tractable, it is restricted to a cohort aged 50 to 59, whereas BPH can affect all men; and (2) a closed cohort approach does not include the costs of new (incident) cases.

Conclusion: Canadian clinical guidelines recommend the use of the combination of tamsulosin and dutasteride for men with moderate/severe symptoms associated with BPH and enlarged prostate volume. This analysis, using a representational patient group, suggests that the FDC is a more cost-effective treatment option for BPH.

 

Downloads

Download data is not yet available.

Author Biographies

Amyn P. Sayani, GlaxoSmithKline, Inc.

Currently, Dr. Sayani is a scientific advisor and health outcomes manager in the Medical Affairs group at GSK Canada.

Afisi S. Ismaila, GlaxoSmithKline, Inc.

Dr. Ismaila is Health Economics and Outcomes Program Leader, Medical Affairs, Medical Division, GlaxoSmithKline Canada

Dr. Ismaila is also Assistant Professor (Part-time), Department of Clinical Epidemiology and Biostatistics, McMaster University

Anna Walker, Heron Evidence Development Ltd

Ms. Walker is Associate Consultant, Health Economic Modeling Unit, Heron Evidence Development Ltd

John Posnett, Heron Evidence Development Ltd

Professor Posnett is Senior Vice President, Health Economic Modeling Unit, Heron Evidence Development Ltd

Bruno Laroche, Laval University; Hôpital Saint-François d’Assise

Dr. Laroche is Clinical professor of Urology, Laval University, and Head of surgery in the division of urology at the Hôpital Saint-François d’Assise, Quebec

J. Curtis Nickel, Queen's University; Kingston General Hospital, Kingston, ON

Professor Nickel is Professor of Urology, Queen's University, and also:
CIHR Tier 1 Canada Research Chair in Urologic Pain and Inflammation
Kingston General Hospital

Zhen Su, GlaxoSmithKline, Inc.

Dr. Zhen Su is Director, Primary Care in the Medical Division at GlaxoSmithKline, Inc and is a urologist by training.

Downloads

Published

2014-01-14

How to Cite

Sayani, A. P., Ismaila, A. S., Walker, A., Posnett, J., Laroche, B., Nickel, J. C., & Su, Z. (2014). Cost analysis of fixed-dose combination of dutasteride and tamsulosin compared with concomitant dutasteride and tamsulosin monotherapy in patients with benign prostatic hyperplasia in Canada. Canadian Urological Association Journal, 8(1-2), e1–7. https://doi.org/10.5489/cuaj.755

Issue

Section

Original Research