Table 2.
Service components of BPH diagnosis, treatments for LUTS, and adverse events
| Service | Cost (US$)/cycle | Included utilization | Reference |
|---|---|---|---|
| Initiation of ComboRx | $519 | OVs for diagnosis and titration | 62 |
| therapy | Rx for 2 single-pill tamsulosin/Flomax, finasteride/Proscar (90%) or 1 polytherapy dutasteride+tamsulosin/Jalyn (10%) pill | 63,64 | |
| Ongoing ComboRx therapy | $394 | OVs for check-up (1 visit annually) | 62 |
| Rx for 2 single-pill (90%) and 1 polytherapy (10%) pill | 62 | ||
| Rezūm® procedure and related | $2,489 | OVs for diagnosis, post-procedure assessment, and check-up (1 visit annually) | 62 |
| Urodynamic study, cystoscopy, TRUS (50%), and TUNA | 62 | ||
| Prostiva® procedure and related | $2,489 | OVs for diagnosis, post-procedure assessment, and check-up (1 visit annually) | 62 |
| Urodynamic study, cystoscopy, TRUS (50%), and TUNA | 62 | ||
| UroLift® procedure and related | $6,230 | OVs for diagnosis, post-procedure assessment, and check-up (1 visit annually) | 62 |
| Urodynamic study, cystoscopy, TRUS (50%), and PUL (4 implants) | 62 | ||
| Greenlight® PVP procedure and related | $4,661 | OVs for diagnosis, post-procedure assessment, and check-up (1 visit annually) | 62 |
| Urodynamic study, cystoscopy, TRUS (50%), and PVP | 62 | ||
| TURP procedure and related | $4,821 | OVs for diagnosis, post-procedure assessment, and check-up (1 visit annually) | 62 |
| Urodynamic study, cystoscopy, TRUS (50%), and TURP | 62 | ||
| Dilation for stricture, contracture, or stenosis | $665 | OVs for diagnosis and post-procedure assessment | 62 |
| Cystoscopy, dilation (filaform or dilator), and radiological supervision | 62 | ||
| Urethrotomy stricture, contracture, or stenosis | $1,926 | OVs for diagnosis and post-procedure assessment | 62 |
| Cystoscopy and urethrotomy | 62 | ||
| TURBN for stricture, contracture, or stenosis | $2,892 | OVs for diagnosis and post-procedure assessment | 62 |
| Cystoscopy and TURBN | 62 | ||
| Initiation of Rx therapy for erectile dysfunction | $155 | OVs for diagnosis and titration | 62 |
| Rx for erectile dysfunction (sildenafil), 2 pills per month | 63 | ||
| Ongoing Rx therapy for erectile dysfunction | $31 | OV for check-up (1 annually) | 62 |
| Rx for erectile dysfunction | 62 | ||
| Initiation of injections for erectile dysfunction | $399 | OVs for diagnosis and assessment | 62 |
| Injections in-office | 62 | ||
| Ongoing injections for erectile dysfunction | $66 | OV for check-up (1 annually) | 62 |
| Rx for self-injections (33% each branded Caverject, generic PEG-1, and generic Tri-mix) | 65 | ||
| Initiation of Rx therapy for incontinence | $579 | OVs for diagnosis and titration | 62 |
| Rx for incontinence (33% each branded Vesicare, generic oxybutynin, and generic tolterodine) | 66,67 | ||
| Ongoing Rx therapy for incontinence | $454 | OV for check-up (1 annually) | 62 |
| Rx for incontinence | 62 | ||
| Initiation of PTNS therapy for incontinence | $2,007 | OVs for diagnosis and 12 weekly treatments | 62 |
| OVs monthly for maintenance therapy | 62 | ||
| Ongoing PTNS therapy for incontinence | $795 | OVs monthly for maintenance therapy | 62 |
| OV for check-up (1 annually) | 62 | ||
| Initiation of Botox therapy for incontinence | $1,798 | OVs for diagnosis and assessment | 62 |
| Cystourethroscopy, with injection(s) for chemo-denervation | 62 | ||
| Ongoing Botox therapy | $1,703 | Injections for maintenance of chemo-denervation | 62 |
| OV for check-up (1 annually) | 62 | ||
| AUS procedure for incontinence | $1,239 | OVs for diagnosis and assessment | 62 |
| Cystoscopy, urodynamic study, and AUS procedure | 62 | ||
| Rx for urinary tract infection | $127 | OV for diagnosis and check-up | 62 |
| Rx for urinary tract infection (16% each branded Monurol, generic trimethoprim/sulfamethoxazole, nitrofurantoin, ciprofloxacin, levofloxacin, and cephalexin) | 66–69 | ||
| Temporary therapy for acute urinary retention | $145 | OV for diagnosis | 62 |
| Cystoscopy and insertion of bladder catheter | 62 |
Abbreviations: AUS, artificial urinary sphincter; BPH, benign prostatic hyperplasia; ComboRx, combination prescription drug therapy; Greenlight PVP (or PVP), photovaporization of the prostate; LUTS, lower urinary tract symptoms; OV, office visit; PEG-1, prostaglandin-1; Prostiva, conductive radiofrequency thermal therapy; PTNS, percutaneous tibial nerve stimulation; PUL (or UroLift), prostatic urethral lift; Rezūm, convective radiofrequency water vapor thermal therapy; Rx, prescription; Tri-mix, alprostadil, papaverine, and phentolamine; TRUS, transurethral ultrasound; TUNA, transurethral needle ablation; TURBN, transurethral resection of the bladder neck; TURP, transrectal resection of the prostate.