OBJECTIVES: Treatment options for men with moderate-to-severe lower urinary tract symptoms (LUTs) due to benign prostatic hyperplasia (BPH) lead to different healthcare costs. This study sought to determine the budget-impact of five treatment options including combination therapy (CT) of tamsulosin and dutasteride, water vapor thermal therapy (WVTT), prostatic urethral lift (PUL), photoselective vaporization of the prostate (PVP), and transurethral resection of the prostate (TURP) for the treatment of BPH.

METHODS: An Excel-based Markov budget impact model was developed in Excel to quantify the financial consequences of CT, WVTT, PUL, PVP, and TURP from a U.S. Medicare perspective, using time horizons of 1 and 5 years. Clinical inputs were obtained from a systematic literature review of randomized and non-randomized clinical trials that reported changes in International Prostate Symptom Score (IPSS), adverse events, and retreatment rates. A random-effects network meta‐analysis was used to account for the differences in patient baseline characteristics between trials. Procedural costs were based on 2022 Medicare reimbursement rates. Sensitivity and scenario analyses were performed.

RESULTS: Total Medicare costs at year 1 were highest for PUL ($8,260) and lowest for WVTT ($2,102). At year 5, total Medicare costs for PUL remained the highest ($9,665), followed by CT ($8,688), TURP ($6,495), PVP ($6,299), and WVTT ($2,794). If 3% of all newly diagnosed BPH men in the U.S. (N=450,000) were treated with WVTT instead of the other treatment options, the annual Medicare spending at 1 year for the same population could be reduced, ranging from $1.2 million (versus CT) to $83 million (versus PUL).

CONCLUSIONS: This study provides evidence of the financial consequences of five common treatment options for men with BPH. WVTT is a cost-saving treatment option that should be considered in resource-constrained environments.