[Efficacy, safety and cost of Qianlieshutong Capsules in the treatment of chronic prostatitis]

OBJECTIVE

To comprehensively evaluate the clinical effect, safety and cost of Qianlieshutong Capsules (QC) in the treatment of chronic prostatitis.

METHODS

We searched Cochrane Library, PubMed, Springer, ProQuest, CNKI, Wanfang Data and VIP for randomized controlled trials (RCT) on the treatment of chorionic prostatitis with QC published from January 2000 to May 2018. According to the inclusion and exclusion criteria, two researchers independently completed the screening and evaluation of the articles, extraction of information, and meta-analysis of the included RCTs using the RevMan 5.3 software.

RESULTS

Totally 10 RCTs involving 1 796 cases were included in this study, in which the chronic prostatitis patients treated by the combination of QC and quinolones all showed a significantly better response than the controls (P < 0.05). QC combined with quinolones cost an average of ¥23 more than quinolones alone with a 1% increase of therapeutic effectiveness, ¥38.39 more with a 1-unit reduction of WBCs, and ¥38.84 more with a 1-point decrease in the NIH-CPSI score.

CONCLUSIONS

The combination of QC with quinolones has a better therapeutic efficacy but a higher cost than quinolones alone in the treatment of chronic prostatitis.

[A pharmacological cost-effective analysis of vobenzim use in combined treatment of chronic prostatitis]

A pharmacological cost-effective analysis of systemic enzymotherapy combination with fluoroquinolone antibiotics in the treatment of chronic bacterial prostatitis showed cost-effect of such therapy: medical cost efficacy of the treatment of chronic bacterial prostatitis with antibiotic + vobenzim is 2 times higher than of antibiotic treatment only.

Prostatitis

PURPOSE

We quantified the burden of prostatitis in the United States by identifying trends in the use of health care resources and estimating the economic impact of the disease.

MATERIALS AND METHODS

The analytical methods used to generate these results were described previously.

RESULTS

The rate of national inpatient hospitalizations for a diagnosis of prostatitis decreased by 21% between 1994 and 2000. Hospitalization rates were 2 to 2.5 times higher for Medicare beneficiaries with a 42% decrease between 1992 and 2001. Combined physician outpatient and hospital outpatient visits revealed an age adjusted, annualized visit rate for prostatitis of 1,798/100,000 population. More than 6% of visits with a primary diagnosis of prostatitis had a concomitant diagnosis of benign prostatic hyperplasia. The most common medications associated with any visits for prostatitis were quinolones (annualized rate 319/100,000 population) and the rate remained about the same even after visits for infectious prostatitis were removed from the data. The cost of prostatitis was about $84 million annually, exclusive of pharmaceutical spending. Of 897 privately insured men with a medical claim for prostatitis in 2002, 14% missed some work because of the condition.

CONCLUSIONS

Overall spending in the United States for the diagnosis and management of prostatitis, exclusive of pharmaceutical spending, totaled $84 million in 2000 and it appears to be increasing with time. Given the extensive gaps in our understanding of the diagnosis of and treatment for prostatitis, many of these expenditures may represent a waste of resources.

[Cost effectiveness of screening for prostate cancer]

According to most experts, problems of prostate cancer (PC) have reached world-wide social and economic resonance at the turn of the 21st century. Costly programs of diagnosis and treatment of generalized PC and its complications require most spending. The general demographic situation and increased aging of male populations, both worldwide and in this country, make it clear that the total costs of medical aid to PC patients will inevitably grow. However, programs of screening for PC can help.

Prostatitis: the cost of disease and therapies to patients and society

Prostatitis is an elusive clinical phenomenon that has become a synonymous term to describe a plethora of lower urinary tract symptoms in men including urinary problems, sexual dysfunction, and pelvic pain. Although symptom presentation has been standardized, an accurate, consistent clinical diagnosis continues to be elusive at best. As a result, recurrence is common, quality of life is compromised, and the patients and society feel the cost of this disease.

The economic impact of chronic prostatitis

BACKGROUND

Little information exists on the economic impact of chronic prostatitis. The objective of this study was to determine the direct and indirect costs associated with chronic prostatitis.

METHODS

Outcomes were assessed using a questionnaire designed to capture health care resource utilization. Resource estimates were converted into unit costs with direct medical cost estimates based on hospital cost-accounting data and indirect costs based on modified labor force, employment, and earnings data from the US Census Bureau.

RESULTS

The total direct costs for the 3 months prior to entry into the cohort, excluding hospitalization, were $126 915 for the 167 study participants for an average of $954 per person among the 133 consumers. Of the men, 26% reported work loss valued at an average of $551. The average total costs (direct and indirect) for the 3 months was $1099 per person for those 137 men who had resource consumption with an expected annual total cost per person of $4397. For those study participants with any incurred costs, tests for association revealed that the National Institutes of Health Chronic Prostatitis Symptom Index (P<.001) and each of the 3 subcategories of pain (P =.003), urinary function (P =.03), and quality-of-life (P =.002) were significantly associated with resource use, although the quality-of-life subscale score from the National Institutes of Health Chronic Prostatitis Symptom Index was the only predictor of resource consumption.

CONCLUSIONS

Chronic prostatitis is associated with substantial costs and lower quality-of-life scores, which predicted resource consumption. The economic impact of chronic prostatitis warrants increased medical attention and resources to identify and test effective treatment strategies.

Healthcare use and costs of primary and secondary care patients with prostatitis

OBJECTIVES

To examine and identify predictors of healthcare use and prostatitis-related and total healthcare costs for primary and secondary care patients with new episodes of care for prostatitis.

METHODS

We compared the use and costs for 270 men with a new episode of care for prostatitis to those of randomly selected male health maintenance organization enrollees matched by age and primary care provider. We examined the episode of care (index visit and next 2 months) and the previous and subsequent years. Patients with prostatitis were interviewed 1 month after the index visit.

RESULTS

Compared with controls, patients with prostatitis had significantly greater total healthcare use (P <0.001) and costs (P <0.05) in each period. The prostatitis costs were only a small proportion of the total costs of the patients with prostatitis and of the difference in costs between patients with prostatitis and controls. The 10% of patients with prostatitis with the greatest total costs accounted for about one half of all costs. White race (P = 0.04), less education (P = 0.02), greater disability (P = 0.003), and greater number of non-pelvic pain sites (P = 0.004) at baseline predicted greater total healthcare costs after the index visit.

CONCLUSIONS

Health maintenance organization enrollees who seek care for prostatitis have greater total healthcare use and costs than do other enrollees of the same age and primary care provider. Most of the difference in costs reflects care for problems other than prostatitis. A small proportion of patients account for most of the costs.