Using a fixed combination of therapies in patients suffering with benign prostatic hyperplasia (BPH) can result in higher levels of treatment persistence, according to a new Italian study. The recently published research focused on the economic value of using fixed combination therapy for the treatment of BPH when compared with free drug combinations, and resulted in a reported €24.3 million savings in hospital costs (the current equivalent to $27.8 million).
The study titled “Benign Prostatic Hyperplasia – An economic assessment of fixed combination therapy based on a literature review” was conducted by both the FederAnziani Senior Italia and the SIU – Italian Society of Urology, and recently included in the U.S. National Library of Medicine – National Institutes of Health (NIH). The research revealed the economic superiority of fixed combination treatments.
“FederAnziani Senior Italia and SIU – Italian Society of Urology – have decided to work together to draft a document focussing on Benign Prostatic Hyperplasia (BPH), and to stress the importance of adherence with pharmacological treatment in this setting, from both a scientific and a patient standpoint,” explained study authors Roberto Messina, president of the FederAnziani Senior Italia and Vincenzo Mirone, general secretary of SIU.
Based on the literature reviewed, the association analyzed the increasingly high levels of therapeutic persistence, which are thought to be related to monotherapy rather than free drug combinations. BPH is an urological disease that occurs particularly among older men and is characterized by an enlarged prostate gland. Patients can be treated with either monotherapy, consistent with the use of only one drug, or a drug combination.
The most common drugs indicated for the treatment of BPH are alpha-blockers and 5alpha-reductase inhibitors, but the two classes of medication are often used in combination. The new study supports the use of a fixed combination therapy, since the authors believe it can result in a higher persistence due to lower numbers of patients abandoning treatment over time. Implementing the use of 5α-reductase inhibitors would result in about €24.3 million annual hospital savings, per every €10.6 million extra expenditure in medication.
The research only focused on patients prescribed with medication included in the 5α-reductase inhibitors class, since investigators believe these compounds are the ones with greatest advantages for BPH patients, particularly older ones. In addition to economic benefits, drug combination therapy reduces the probability of acute urinary retention (AUR) by 14%, and surgery by 11%.
Nonetheless, these results contradict previous research, including a study titled “Monotherapy versus combination drug therapy for the treatment of benign prostatic hyperplasia,” published in 2005, which compiles a series of results that failed to support the theory that combination therapy is preferred over alpha-blockers alone.