Efficiency of the combination therapy dutasteride and tamsulosin for the treatment of benign prostate hyperplasia in Spain =Eficiencia de la combinación dutasterida y tamsulosina para el tratamiento de la hiperplasia benigna de próstata en España

Objectives: To evaluate the efficiency of combination therapy with tamsulosin and dutasteride (TAM+DUT) as an initial therapy versus the common practice of starting treatment with TAM and at month 6 add DUT (delayed onset), in patients with moderate to severe benign prostate hyperplasia (BPH) with risk of progression. Methods: A Markov model was developed using a 4-year horizon and from the Spanish National Healthcare Service (NHS) perspective. Data were obtained from CombAT and Naslund et al. trials. Health outcomes were expressed as percentage of complications (acute urinary retention and surgery). Health care resources were defined by an experts' panel, and unitary costs were obtained from published Spanish sources. Pharmacologic cost is expressed in final retail price. Costs are expressed in €2010. Results: Initial treatment with TAM+DUT is an efficient pattern of treatment compared with delaying the onset of combination therapy, by reducing in 15% the probability of having a complication with lower health care costs associated at 4 years. Conclusions: Starting treatment with TAM+DUT is a more efficient pattern of treatment than the common practice of delaying the onset of a combination therapy. The adoption of more efficient treatments could help to improve the efficiency of the Spanish NHS. Adis © 2012 Springer International Publishing AG. All rights reserved.