Costs of benign prostatic hyperplasia treatment in Montenegro

Introduction/Aim. Benign prostatic hyperplasia (BPH) is one of the most frequent diseases in men older than 50 years, and it is closely linked to ageing process. Considering rising life expectancy, further increase in prevalence of BPH could be expected.  The aim of our study was to analyze costs of treating patients with BPH in Montenegro, in order to estimate their impact on health budget. М ethods . The BPH treatment costs were analyzed in a random sample of 47 male patients, 50 years of age or older, taken from the population of patients with BPH treated in Hospital Niksic, Montenegro, during year 2013. The patients were in one of the five health states: mild symptoms of BPH, moderate symptoms of BPH, severe symptoms of BPH, acute urinary retention , and transurethral resection of the prostate (TURP). Only direct medical costs were taken into account when calculating costs of each health state. The costs were calculated on the basis of utilization of services, drugs and materials, taken from the patients’ medical records, and utilization figures were multiplied with prices recognized by the Health Insurance Fund, Montenegro. Total number of patients with BPH in Montenegro was taken from the database of Institute for Public Health, Montenegro. The costs are expressed in euros (EUR). Results. Average annual costs of treating a patient with certain BPH health state were: mild BPH - 266,63 ЕUR, moderate BPH - 343,26 EUR, severe BPH - 413,51 EUR, acute urinary retention - 493,93 ЕUR and  TURP - 1.013,16 ЕUR. Total costs of treating all patients with BPH in Montenegro are 2.338.008,66 ЕUR; this amount makes 1,43% of total Montenegrian health budget. The largest part of the costs make medication acquisition costs, especially those spent for finasteride (196.341,11 ЕUR) and antimicrobials. According to the data generated by Montenegrian Drug Agency, annual turnover of all drugs indicated for treatment of BPH in 2011 was 595.948,74 ЕUR, and from this amount, 251.157,66 ЕUR was paid by Montenegrian Health Insurance Fund. During the period 2006 – 2011, number of patients with BPH increased for 370%, and the annual amount spent for BPH drugs increased for 373%. Conclusion. Costs of treating BPH in Montenegro make significant percent of total healthcare costs, and there is trend of increase in costs due to constant increase in number of patients with BPH in Montenegro.