Cost of illness of medically treated benign prostatic hyperplasia in Hungary.

Objective: To perform a cost of illness study in lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH) in Hungary.
Methods: A multicentre, cross-sectional survey was carried out in 2014. BPH patients who had never undergone prostate surgery were recruited to the study. EQ-5D and the International Prostate Symptom Score (IPSS) were used to evaluate health status and disease severity. All resource utilisations related to BPH in the past 12 months were recorded. Cost analysis was performed from societal perspective.
Results: Overall, 246 patients were included with mean age of 70.6 (SD 8.1) years. Mean EQ-5D and IPSS were 0.85 (SD 0.19) and 12.8 (SD 6.3). Total annual per patient cost of BPH amounted to <euro>876 (SD <euro>1829). Distribution of the costs between direct medical, direct non-medical and indirect cost was 46, 31 and 23 %. High costs were related to informal care (<euro>243), medications (<euro>178) and private physician visits (<euro>132). Patients missed from work on average 14 h/year and 20 h/year due to absenteeism and presenteeism. Clinical severity expressed in IPSS score was found the strongest predictor of higher total costs (r = 0.429, p < 0.001). Mean costs of mild, moderate and severe patients were <euro>203, <euro>754 and <euro>2168, respectively.
Conclusions: To our knowledge, this is the first study in the literature that assessed indirect costs related to presenteeism in BPH. We found that costs of reduced productivity while working exceed costs of absence from work. As the retirement age is gradually increasing, the importance of presenteeism is getting more significant, especially in pursuit of sustainable employment.