Medical therapy for benign prostatic hyperplasia--present and future impact.

The purpose of this manuscript is to provide clinicians, health plan decision makers, and policy makers with highlights of key findings pertaining to our current understanding of the condition of enlarged prostate (EP) from a managed care perspective. This includes a brief discussion regarding the prevalence and economic burden of EP, followed by a review of clinical characteristics and pathophysiology, with the final section on treatment approaches with a focus on pharmacologic options. This supplement is not intended to be a comprehensive review of EP, because many review articles on this subject are available elsewhere. This manuscript does, however, serve to introduce 3 additional manuscripts contained within this supplement. The first article provides the readers with a real-world comparison of dutasteride and finasteride relative to acute urinary retention and surgery attenuation rates. The second article investigates differences in discontinuation rates of alpha blockers when used in combination with dutasteride or finasteride. The last article addresses the cost implications associated with dutasteride and finasteride therapy. All 3 articles represent data from a naturalistic, managed care population. This supplement is intended to assist managed care formulary decision makers in evaluating key clinical and economic data which could help to differentiate dutasteride and finasteride. Although the information presented does not prove superiority of either product, it will answer some important questions and raise some important issues beyond ingredient cost.