Goldstein Irwin, Hassan Tarek, Zou Kelly, Divino Victoria, DeKoven Mitch, Imperato Joseph, Anupindi Vamshi Ruthwik, Li Jim
Department of Sexual Medicine, Alvarado Hospital, San Diego, CA, USA.
Department of Urology, Viatris Inc, Canonsburg, PA, USA.
Patient Prefer Adherence. 2023 Sep 6;17:2187-2200. doi: 10.2147/PPA.S412969. eCollection 2023.
To compare health-care resource utilization (HCRU) outcomes in patients with erectile dysfunction (ED) and benign prostatic hyperplasia-associated lower urinary tract symptoms (BPH-LUTS) treated with tadalafil or non-phosphodiesterase-5 inhibitor (PDE5i), adherence to and persistence with tadalafil by dose in the United States (US).
This was a noninterventional, real-world evidence study of men (aged ≥45 years) with ED and BPH-LUTS treated with tadalafil or non-PDE5i. The IQVIA US PharMetrics Plus claims database was used. Outcomes included all-cause and disease-specific HCRU over a 12-month follow-up. Persistence with and adherence to tadalafil were evaluated stratified by dose (10 or 20 mg as needed; 2.5 or 5 mg as once daily [OD]).
The final sample comprised 11,351 tadalafil and 48,722 non-PDE5i patients. For all-cause and disease-specific HCRU, including prescription fills, physician office visits, emergency room visits, laboratory tests, radiology examinations, outpatient surgical services, ancillary services, hospitalizations, mean number of utilizations, and proportions of patients with one or more utilizations, were lower for tadalafil compared with non-PDE5i patients. For all-cause HCRU, proportions of patients with one or more emergency room visits (18.6% vs 21.7%, <0.0001) and outpatient surgical visits (63.0% vs 68.8%, <0.0001) were significantly lower for tadalafil compared with non-PDE5i patients. For disease-specific HCRU, the proportion with one or more disease-specific physician office visits (55.1% vs 91.4%), laboratory tests (34.8% vs 58.2%), outpatient surgery (24.3% vs 38.9%), or outpatient ancillary services (18.0% vs 29.8%) were significantly lower for tadalafil compared with non-PDE5i patients (all comparisons, <0.0001). Mean persistence days (179.8 vs 61.2), proportion persistence (35.8% vs 6.5%), and mean adherence (0.5 vs 0.2) were higher for tadalafil OD doses than as-needed tadalafil doses.
Patients on tadalafil demonstrated less HCRU and higher persistence and adherence (OD versus as-needed tadalafil) than non-PDE5i patients, which demonstrates its benefit in the management of ED and BPH-LUTS in the US.
比较在美国接受他达拉非或非磷酸二酯酶-5抑制剂（PDE5i）治疗的勃起功能障碍（ED）患者和良性前列腺增生相关下尿路症状（BPH-LUTS）患者的医疗资源利用（HCRU）结果，以及按剂量划分的他达拉非的依从性和持续性。
这是一项针对接受他达拉非或非PDE5i治疗的年龄≥45岁的ED和BPH-LUTS男性患者的非干预性真实世界证据研究。使用了IQVIA美国PharMetrics Plus索赔数据库。结果包括12个月随访期间的全因和疾病特异性HCRU。按剂量（按需10或20毫克；每日一次[OD]2.5或5毫克）分层评估他达拉非的持续性和依从性。
最终样本包括11351名他达拉非患者和48722名非PDE5i患者。对于全因和疾病特异性HCRU，包括处方配药、医生门诊就诊、急诊室就诊、实验室检查、放射学检查、门诊手术服务、辅助服务、住院治疗、平均利用次数以及有一次或多次利用的患者比例，他达拉非组均低于非PDE5i组。对于全因HCRU，他达拉非组有一次或多次急诊室就诊的患者比例（18.6%对21.7%，<0.0001）和门诊手术就诊的患者比例（63.0%对68.8%，<0.0001）显著低于非PDE5i组。对于疾病特异性HCRU，他达拉非组有一次或多次疾病特异性医生门诊就诊（55.1%对91.4%）、实验室检查（34.8%对58.2%）、门诊手术（24.3%对38.9%）或门诊辅助服务（18.0%对29.8%）的患者比例显著低于非PDE5i组（所有比较，<0.0001）。他达拉非OD剂量组的平均持续天数（179.8对61.2）、持续比例（35.8%对6.5%）和平均依从性（0.5对0.2）高于按需服用他达拉非剂量组。
与非PDE5i患者相比，接受他达拉非治疗的患者表现出更少的HCRU以及更高的持续性和依从性（OD服用他达拉非与按需服用他达拉非相比），这表明其在美国ED和BPH-LUTS管理中的益处。
