A COST COMPARISON OF MEDICAL MANAGEMENT AND TRANSURETHRAL NEEDLE ABLATION FOR TREATMENT OF BENIGN PROSTATIC HYPERPLASIA DURING A 5-YEAR PERIOD

ABSTRACTPurpose:We performed an analysis comparing the cost of medical management with TUNA® therapy for a 5-year period.Materials and Methods:Published costs for tamsulosin, finasteride, transurethral needle ablation (TUNA®, Medtronic, Inc., Minneapolis, Minnesota) and transurethral resection of the prostate were used to construct a cost analysis model comparing medication with TUNA. The model analyzed monotherapy with an α-blocker (tamsulosin) and a 5α-reductase inhibitor (finasteride), combination therapy using both medications, and a mixed scenario using monotherapy and combination therapy. Published data were used to estimate the rate of surgical intervention in patients initially treated with medications or TUNA.Results:Tamsulosin monotherapy was less expensive than TUNA for 5 years ($3,485 for tamsulosin vs $4,811 for TUNA year 5). Finasteride monotherapy reaches a break-even point with TUNA during year 5 ($4,867 for finasteride vs $4,811 for TUNA). Combination therapy reaches a break-even point with TUNA after approximately 2 years 7 months of treatment ($4,515 for combination therapy vs $4,572 for TUNA) and the mixed scenario breaks even with TUNA at approximately year 4 ($4,696 for medical management vs $4,645 for TUNA).Conclusions:The TUNA procedure compares favorably to combination medical therapy for the treatment of benign prostatic hyperplasia on a cost basis. α-Blocker monotherapy is less costly than TUNA while 5α-reductase inhibitor monotherapy is approximately equivalent to TUNA for 5 years. The TUNA procedure is less expensive than combination medical management for 5 years, with a break-even point at approximately 2 years 7 months.