PD33-06: National Prescribing Trends in Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia

Kevin McVary, Julia B. Ward , Lydia Feinstein , Kevin C. Abbott, Tamara Bavendam, Ziya Kirkali, Erline Martinez-Miller, Brian R. Matlaga, Charles Welliver

Introduction: Lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) is a chronic disease causing significant morbidity and quality of life impairment among adult men. Pharmacotherapy is the most common initial intervention, but our current understanding of medication usage trends for LUTS/BPH is incomplete and prior studies have relied on limited datasets that have predominantly focused on older men. We assessed trends in the pharmacological management of LUTS/BPH among a national sample of men with private and Medicare insurance over an 8-year period.

Methods: As part of the Urologic Diseases in America project, two insurance claims databases were analyzed over the 2006-2013 study period: the Centers for Medicare & Medicaid Services Medicare (CMS) 5% Sample for an annual average of 105,180 male Medicare beneficiaries aged =65 years with LUTS/BPH and the Optum© de-identified Clinformatics® Data Mart Database (CDM) for an annual average of 104,766 privately insured males aged 40-64 years with LUTS/BPH. The percentage of patients receiving LUTS/BPH-related prescriptions was assessed annually over the study period and stratified by 5-year age groups.

Results: Use of prescription medications for LUTS/BPH increased throughout the study period (see Figure). The increase was greater for men with private insurance as compared to Medicare (14% vs 5% increase). The proportion of patients who filled prescriptions increased with increasing age, with up to 67% of LUTS/BPH patients aged 85+ years filling prescriptions in 2013.

Conclusions: Over an 8-year study period, BPH was increasingly managed with pharmacotherapy. This increase was especially pronounced among younger men with private insurance. This analysis is unique in that the utilization of administrative claims data allowed for assessment of prescribing trends across different care delivery settings and among a large national sample of men as young as 40 years of age. Source of

Funding: Funded by the NIH via a contract to Social & Scientific Systems.