Critical evaluation of a decision-analytic model of BPH treatment options

Therapeutic interventions of benign prostatic hyperplasia (BPH) include surgical procedures, drug treatment with alpha blockers and 5-alpha-reductase inhibitors, and watchful waiting. This month's column presents a step-by-step evaluation of a published decision-analytic model that compares finasteride with both watchful waiting and terazosin. Aside from learning how to critically assess a published pharmacoeconomic study, health care decision makers interested in conducting an economic evaluation in this clinical area can review the inputs used in constructing the original economic evaluation critiqued in this article. Health care decision makers should also take note of the more recent, long-term studies of finasteride used as part of the basis for the economic model. These studies considered acute urinary retention and prostate size, which are more important predictors in successful treatment with finasteride.