Evolution of healthcare costs for lower urinary tract symptoms associated with benign prostatic hyperplasia

Purpose With the ubiquity of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH) in older men, costs related to this highly prevalent disease are likely significant but not well defined. With this study, we hoped to define costs related to LUTS/BPH care. Methods We utilized the Optum (c) de-identified Clinformatics (R) Data Mart Database (CDM) for privately insured male enrollees aged 40-64 years with LUTS/BPH (N approximate to 100,300 annually) and the Centers for Medicare and Medicaid Services Medicare 5% Sample for male beneficiaries aged 65 + years with LUTS/BPH (N approximate to 147,800 annually). Annual LUTS/BPH-related expenditures from 2004 to 2013 were age standardized and calculated overall and by age and service location. Results The Medicare cohort demonstrated a 23% increase in total costs over the study period with a 28% decrease in CDM costs. Decreases in inpatient hospital charges (45% for Medicare, 55% for CDM) were offset by increasing hospital-based outpatient fees (120% for Medicare, 87% for CDM). Overall, we estimated a total cost of at least $1.9 billion for treatment of men with LUTS/BPH for 2013. Per person expenditures increased with age within cohorts with an average per-person cost of $269 (CDM) and $248 (Medicare) in 2013. Conclusion The distribution of healthcare expenditures for LUTS/BPH shifted across practice settings from 2004 to 2013, with increasing outpatient relative to inpatient expenditures. Total direct costs for LUTS/BPH in 2013 were at least $1.9 billion, not accounting for indirect costs or certain unmeasured populations.

Automated summary

The study aimed to define costs related to lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH) care. The findings showed that the medical expenses for LUTS/BPH increased over the years, with outpatient fees in healthcare facilities gradually rising while inpatient charges decreased. The estimated total direct costs for LUTS/BPH in 2013 were at least $1.9 billion.