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BMC Cancer
Published in: BMC Cancer 1/2016

Open Access 01-12-2016 | Research article

A cost effective analysis of fixed-dose combination of dutasteride and tamsulosin compared with dutasteride monotherapy for benign prostatic hyperplasia in Nigeria: a middle income perspective; using an interactive Markov model

Authors: Emeka I. Udeh, Chimaobi G. Ofoha, David A. Adewole, Ikenna I. Nnabugwu

Published in: BMC Cancer | Issue 1/2016

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Abstract

Background

The number of Nigerian men presenting with benign prostatic hyperplasia is on the rise because of increase awareness about the ailment. With the renewed effort by the national health insurance scheme to cover the informal sector, it becomes imperative to determine the cost implication for managing Benign Prostatic Hyperplasia (BPH) and the cost effective drug combination to be adopted. The objective of this study is to estimate cost effective analysis (CEA) of fixed -dose combination of dutasteride and tamsulosin compared with dutasteride monotherapy from the health service provider perspective design.

Methods

An interactive Markov’s model was used to generate incremental cost per QALY and incremental cost per life years gained. 2.9 million Men who were 50 years of age were fed into the model. The outcome measures included: costs of drug treatment, consultation, acute urinary retention (AUR), transurethral resection of prostate (TURP), hospitalisation post TURP, and quality adjusted life years (QALYs), incremental cost per life years gained, and incremental cost per QALY gained.

Results

Fixed-dose combination of dutasteride and tamsulosin (FDCT) produced an Incremental cost-effectiveness ratios of US$1481.92 per Quality adjusted for life-years saved.

Conclusion

Universal FDCT provision for Nigeria has major economic implications. This study in the context of its limitations has demonstrated the cost effectiveness of FDCT for the long term treatment of patients with moderate to severe BPH from the perspective of a developing country. Currently, there are few studies available to give economic data evidence to policy makers in Nigeria which is applicable to developing countries with similar economies. As such, the findings in this study will be relevant to policy makers in these countries.
Literature
1.
Desgrandchamps F, de la Taille A, Azzouzi A-R, Fourmarier M, Haillot O, Lukacs B, et al. Management of non-complicated BPH: proposition of a renewed decision tree. World J Urol. 2006;24(4):367–70.CrossRefPubMed
2.
Madersbacher S, Alivizatos G, Nordling J, Sanz CR, Emberton M, de la Rosette JJ. EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines). Eur Urol. 2004;46(5):547–54.CrossRefPubMed
3.
Speakman M, Kirby R, Joyce A, Abrams P, Pocock R. Guideline for the primary care management of male lower urinary tract symptoms. BJU Int. 2004;93(7):985–90.CrossRefPubMed
4.
Ezeanyika LU, Ejike CE, Obidoa O, Elom SO. Prostate disorders in an apparently normal Nigerian population 1: Prevalence. Biokemistri. 2006;18(2):127–32.
5.
6.
McConnell JD, Roehrborn CG, Bautista OM, Andriole Jr GL, Dixon CM, Kusek JW, et al. The Long-Term Effect of Doxazosin, Finasteride, and Combination Therapy on the Clinical Progression of Benign Prostatic Hyperplasia. N Engl J Med. 2003;349(25):2387–98.CrossRefPubMed
7.
Djavan B, Dianat SS, Kazzazi A. Effect of combination treatment on patient-related outcome measures in benign prostatic hyperplasia: clinical utility of dutasteride and tamsulosin. Patient Relat Outcome Meas. 2011;2:71–9.CrossRefPubMedPubMedCentral
8.
Dull P, Reagan RW, Bahnson RR. Managing benign prostatic hyperplasia. Am Fam Physician. 2002;66(1):77–90.PubMed
9.
McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruskewitz RC, Donnell RF, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185(5):1793–803.CrossRefPubMed
10.
Boyle P, Roehrborn C, Harkaway R, Logie J, de la Rosette J, Emberton M. 5-Alpha reductase inhibition provides superior benefits to alpha blockade by preventing AUR and BPH-related surgery. Eur Urol. 2004;45(5):620–7.CrossRefPubMed
11.
Djavan B, Marberger M. A meta-analysis on the efficacy and tolerability of α1-adrenoceptor antagonists in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction. Eur Urol. 1999;36(1):1–13.CrossRefPubMed
12.
Souverein P, Erkens J, de la Rosette J, Leufkens H, Herings R. Drug treatment of benign prostatic hyperplasia and hospital admission for BPH-related surgery. Eur Urol. 2003;43(5):528–34.CrossRefPubMed
13.
Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Nandy I, et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol. 2010;57(1):123–31.CrossRefPubMed
14.
Debruyne F, Barkin J, Erps PV, Reis M, Tammela TL, Roehrborn C. Efficacy and safety of long-term treatment with the dual 5α-reductase inhibitor dutasteride in men with symptomatic benign prostatic hyperplasia. Eur Urol. 2004;46(4):488–95.CrossRefPubMed
15.
Federal Ministry of Health. In: Health FMo, editor. Standard Treatment Guideline. Nigeria: Federal Ministry of health; 2005. p. 220.
16.
Barkin J. Review of dutasteride/tamsulosin fixed-dose combination for the treatment of benign prostatic hyperplasia: efficacy, safety, and patient acceptability. Patient Prefer Adherence. 2011;5:483–90.CrossRefPubMedPubMedCentral
17.
Warusawitharana M. In: System BoGotFR, editor. The Social Discount Rate in Developing Countries. Washington: FEDS; 2014.
18.
19.
Badmus T, Asaleye C, Badmus S, Takure A, Ibrahim M, Arowolo O. Benign prostate hyperplasia: average volume in southwestern Nigerians and correlation with anthropometrics. Niger Postgrad Med J. 2013;20(1):52–6.PubMed
20.
21.
Kiemeney LA, Bosland MC. Dutasteride and prostate cancer. N Engl J Med. 2010;363(8):793. author reply 794–795.CrossRefPubMed
22.
Ismaila A, Walker A, Sayani A, Laroche B, Nickel JC, Posnett J, et al. Cost-effectiveness of dutasteride-tamsulosin combination therapy for the treatment of symptomatic benign prostatic hyperplasia: A Canadian model based on the CombAT trial. Can Urol Assoc J. 2013;7(5–6):E393–401.PubMedPubMedCentral
23.
McDonald H, Hux M, Brisson M, Bernard L, Nickel J. An economic evaluation of doxazosin, finasteride and combination therapy in the treatment of benign prostatic hyperplasia. Can J Urol. 2004;11(4):2327–40.PubMed
24.
Geitona M, Karabela P, Katsoulis IA, Kousoulakou H, Lyberopoulou E, Bitros E, et al. Dutasteride plus tamsulosin fixed-dose combination first-line therapy versus tamsulosin monotherapy in the treatment of benign prostatic hyperplasia: a budget impact analysis in the Greek healthcare setting. BMC Urol. 2014;14:78.CrossRefPubMedPubMedCentral
25.
Bjerklund Johansen TE, Baker TM, Black LK. Cost-effectiveness of combination therapy for treatment of benign prostatic hyperplasia: a model based on the findings of the Combination of Avodart and Tamsulosin trial. BJU Int. 2012;109(5):731–8.CrossRefPubMed
26.
Oppe M, Devlin NJ, Szende A. EQ-5D value sets: inventory, comparative review and user guide. Dordrecht: Springer; 2007.
Metadata
Title
A cost effective analysis of fixed-dose combination of dutasteride and tamsulosin compared with dutasteride monotherapy for benign prostatic hyperplasia in Nigeria: a middle income perspective; using an interactive Markov model
Authors
Emeka I. Udeh
Chimaobi G. Ofoha
David A. Adewole
Ikenna I. Nnabugwu
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2016
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-016-2431-x

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