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Establishing the Benefits of Adherence to Enlarged Prostate Treatment: A Validation Study Linking Adherence to Outcomes Using the Market Scan Database

Completed
Conditions
Prostatic Hyperplasia
Interventions
Drug: 5-alpha Reductase Inhibitor (5ARI)
Registration Number
NCT01381510
Lead Sponsor
GlaxoSmithKline
Brief Summary

Adherence and length of therapy with 5-alpha reductase inhibitor (5ARI) treatment may be associated with improved clinical outcomes of enlarged prostate (EP) as well as lower health care costs.

The objective of this retrospective database analysis is to quantify the relationship between adherence and length of therapy with a 5ARI and the likelihood of acute urinary retention (AUR) or prostate surgery (emergency and non-emergency) in patients with benign prostatic hyperplasia (BPH). The study will also measure the economic impact associated with these medical encounters.

The MarketScan database contains data from people with commercial health insurance and Medicare and includes both medical and pharmacy data that are sourced directly from health plans and employers. Approximately 18 million covered lives will be utilized for this study in the time period from January 1, 2003 to September 30, 2009.

This study is a retrospective cohort analysis of medical claims data.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
54459
Inclusion Criteria
  • Male
  • Aged 50 years or older
  • A diagnostic claim of benign prostatic hyperplasia (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 222.2x or 600.xx)
  • A prescription claim for a 5-alpha reductase inhibitor (5ARI) for at least 60 days during the observation period
  • Continuous health plan eligibilitiy for 6 months prior to and at least 150 days after the initial 5ARI prescription
Exclusion Criteria
  • A diagnosis of prostate cancer (ICD-9-CM codes 185.xx, 198.82, 233.4, 236.5, 239.5, V10.46)
  • A diagnosis of bladder cancer (ICD-9-CM codes 188.xx, 198.1, 223.3, 233.7, 239.4, V10.51),
  • A procedure code for any prostate-related surgery prior to the index date or 150 days after the index date
  • A diagnosis code for acute urinary retention (AUR) prior to the index date or 150 days after the index date

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Adherent BPH patients5-alpha Reductase Inhibitor (5ARI)Patients with benign prostatic hyperplasia (BPH) who are adherent to 5-alpha reductase inhibitor (5ARI) therapy based on a medication possession ratio (MPR). Analyses will be conducted with threshold adherence levels of 70%, 75% and 80%
Non-adherent BPH patients5-alpha Reductase Inhibitor (5ARI)Patients with BPH who are not adherent to 5ARI therapy based on an MPR and threshold levels of less than 70%, less than 75% and less than 80%
Primary Outcome Measures
NameTimeMethod
The occurence of a diagnosis code for acute urinary retention (AUR) or a procedure code for prostate surgeryOne year following the first date of 5ARI therapy

The occurence of a code for either AUR or prostate surgery will be identified for patients who were adherent with 5ARI therapy as measured with a medication possession ratio (MPR)

Secondary Outcome Measures
NameTimeMethod
Mean costs associated with AUR or prostate surgeryOne year following the first date of 5ARI therapy

The mean costs of outpatient and inpatient visits associated with the diagnosis code for AUR or the procedure codes for prostate surgery will be compared between patients who were compliant with 5ARI therapy and those who were not

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