Urinary symptoms associated with moderate to severe disease can significantly interfere with daily activities and reduce quality of life.
Obstruction of urine flow in men with BPH can result from nonmalignant enlargement of the prostate gland static component of BPH and from alpha 1 receptor-mediated increased smooth muscle tone of the bladder neck and prostate dynamic component of BPH. Transurethral resection of the prostate TURP is generally very effective and has traditionally been the standard treatment for men with moderate to severe BPH. However, response to therapy with TURP is not universal and the chist al glandei is associated with a number of potential complications.
Moreover, many men prefer to avoid or are not suitable candidates for this invasive procedure. Thus, there is an increasing role for less invasive treatment, including drug therapy, in men with moderate to severe BPH. Terazosin is an alpha 1 receptor antagonist which has been shown in placebo-controlled trials to significantly improve American Urology Association AUA symptom and quality-of-life scores and symptom problem index 'bother' scoreas well as increase peak urinary flow rate, in men with BPH.
The analysis, which was conducted from the perspective of a managed care organisation in the US, demonstrated that the lower medication costs in the placebo group relative to the terazosin group were offset by increased inpatient care forum prostate cancer survivors. Another economic analysis, also conducted from a problems of benign prostatic hyperplasia payer perspective in the US, modelled direct treatment costs associated with terazosin, finasteride and TURP problems of benign prostatic hyperplasia the first 2 years after initiating therapy in men with moderate to severe BPH.
A companion break-even cost analysis used a hypothetical cohort of men with BPH starting treatment at age 67 years.
Private insurance costs associated with terazosin remained lower then those associated with TURP for approximately 15 years the corresponding break-even point was 10 years for finasteride vs TRUP. Medicare costs associated with terazosin would not exceed those of TURP for approximately 7 years 5.
In conclusion, a limited number of detailed pharmacoeconomic analysis of terazosin have been conducted to date, although it has not been compared with other a1 receptor antagonists.