Are Costlier Prostate Treatments Really Better?

By Jane Farrell

The cost to treat a benign prostate condition can vary as much as 400 percent, researchers say, and the results were no different. The finding has important implications for health-care costs.

Investigators from UCLA analyzed the cost of treatment for a common condition benign prostate hyperplasia (BPH).

“The rising cost of health care is unsustainable, and a big part of the problem is that health systems, health care providers and policy makers have a poor understanding of how much health care really costs,” said  study first author Dr. Alan Kaplan, a resident physician in the UCLA Department of Urology.  “Until this is well understood, taxpayers, insurers and patients alike will continue to bear the burden of soaring health care costs.”

The one-year study was published in Healthcare: The Journal of Delivery Science and Innovation.

Treatments for BPH can range from minimally invasive, in-office surgery to inpatient open surgery. Kaplan said a significant part of the cost depends on the kind of pre-operative work done on a patient.

“We felt that if we could tackle the cost of such a complex and common condition we could use the technique to really understand cost on a larger scale,” Kaplan said. “Most importantly, we found that within our own institution the cost of treating BPH varied about 400 percent and, as of yet, we have no proof that one way is any better than the other.”

According to a news release from UCLA, Kaplan and his team created “maps” that detailed all the costs involved in varying treatments, including doctors, nurses and patient affairs staffers. They also took into account space and equipment cost.

“Cost can be a dirty word in medicine. People want the best health care money can buy,” Kaplan said. “A poor understanding of health care costs means a lot of waste and unnecessary expenses that are borne mostly by patients.  Value in health care demands high quality care at the lowest possible cost.”

The study was a collaborative effort of the UCLA Department of Urology and the UCLA Institute for Innovations in Health.

The UCLA news release said that according the American Urologic Association, BPH affects about 50 percent of men between 51 and 60 and up to 90 percent of men over 80. The condition is caused by the non-cancerous enlargement of the prostate gland due to aging. Symptoms include difficult and/or frequent urination, dribbling after urination and pain during urination.