Presented by: Kevin Chua MD
Rutgers Robert Wood Johnson Medical School, Department of Surgery, Division of Urology

Introduction

There has been rising usage of minimally invasive techniques for treatment of symptomatic benign prostatic hyperplasia (BPH) including water vapor thermal therapy (WVTT) and prostatic urethral lift (PUL). We hypothesized that the increased adoption of such technologies would lead to a decrease of BPH medication prescriptions and costs.

Materials

The 2013-2020 Medicare Part D Public Use File was used to identify the number of claims and annual expenditure of alpha blockers (AB), 5-alpha reductase inhibitors (5ARI), tamsulosin-dutasteride combination pill, and tadalafil by urologists. Medicare Part B National Summary Data File was used to calculate the number of each BPH procedure per year.

Results

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From 2013 to 2020, total BPH medication claims increased from 5,682,443 in 2013 to 6,874,329 in 2017 but decreased each year afterward to 6,565,868 in 2020 (Figure). Annual expenditure increased from $324,545,652 to $353,369,600 from 2013 to 2015, but then decreased to $167,365,641 by 2020. Dutasteride expenditure decreased by about $100 million from 2014 to 2020. Number of BPH procedures decreased from 106,016 to 100,963 from 2013 to 2015, but then increased to 129,958 in 2019. PUL increased from 0 to 35,639 from 2014 to 2019. WVTT increased from 0 to 7,611 from 2017 to 2019. There was a decrease in procedures in 2020 which is likely due to COVID.

Conclusion

BPH medication prescribing was seen to decrease after 2017 which may demonstrate the effect of increased surgical treatment. The economic burden of BPH medications has also been decreasing over time.

Funding

n/a

Co-Authors

Jake Drobner, BA
Rutgers Robert Wood Johnson Medical School, Department of Surgery, Division of Urology

John Pfail, MD
Rutgers Robert Wood Johnson Medical School, Department of Surgery, Division of Urology

Rachel Passarelli, MD
Rutgers Robert Wood Johnson Medical School, Department of Surgery, Division of Urology

Benjamin Lichtbroun, MD
Rutgers Robert Wood Johnson Medical School, Department of Surgery, Division of Urology

Sai Krishnaraya Doppalapudi, MD
Rutgers Robert Wood Johnson Medical School, Department of Surgery, Division of Urology

Hiren Patel, MD PHD
Rutgers Robert Wood Johnson Medical School, Department of Surgery, Division of Urology

Elias Hyams, MD
Brown University Medical School Division of Urology

Sammy Elsamra, MD
Rutgers Robert Wood Johnson Medical School, Department of Surgery, Division of Urology

Danielle Velez-Leitner, MD
Rutgers Robert Wood Johnson Medical School, Department of Surgery, Division of Urology

Ji Hae Park, MD
Rutgers Robert Wood Johnson Medical School, Department of Surgery, Division of Urology