There is no difference in outcomes among men with benign prostatic hyperplasia (BPH) treated early with two different 5-alpha reductase inhibitors (5-ARIs) in combination with alpha-blockers, according to a study that compared health and economic consequences of the two treatment regimes.
The study, “Comparing Clinical and Economic Outcomes Associated with Early Initiation of Combination Therapy of an Alpha Blocker and Dutasteride or Finasteride in Men with Benign Prostatic Hyperplasia in the United States,” was published in the Journal of Managed Care & Specialty Pharmacy.
Several studies had already shown that combining 5-ARIs with alpha-blockers is a more effective approach to treating lower urinary tract symptoms (LUTS) linked to BPH than treatment with either drug alone. In the U.S., Avodart (dutasteride) and finasteride (sold as brands Propecia and Proscar) are the two most commonly used 5-ARIs.
But no studies had compared the two drugs when used in combination with alpha-blockers.
For the current study, researchers at Analysis Group and GlaxoSmithKline used health care administrative claims, including medical, pharmacy, and enrollment data, to analyze any potential differences in health or economic outcomes.
Researchers identified 2,778 patients treated with Propecia or Proscar in combination with alpha-blockers, and 4,125 patients receiving combination treatment with an alpha-blocker and Avodart.
Patients using Avodart were younger and had fewer other diseases. They also tended to visit the urologist more often, had a larger proportion of claims linked to prostate problems, and were followed on average for a shorter time than patients receiving Propecia or Proscar.
Taking into account those differences in patient characteristics, the analysis showed that there was no difference in the rate of acute urinary retention, prostate-related surgery, or disease progression between the groups.
The analysis showed that the use of Avodart was linked to higher pharmacy costs per month. However, the total all-cause medical costs were not different between the groups. There was also no difference in monthly healthcare costs.
With the exception for all types of outpatient visits (slightly more common in Avodart users) and BPH-related emergency room visits (slightly more common among Propecia or Proscar users) there were no differences in how often patients in the two groups used healthcare resources.