The patient pathway following AUR depended on the treatment success: the two treatment options were emergency catheterization and trial without catheter (TWOC).
The model estimated the following outcomes: costs of drug treatment, costs of consultations, costs of AUR, costs of BPH-related surgery, total costs (including hospitalizations and home care post-surgery or in the event of complications such as incontinence), total quality adjusted life years (QALYs), incremental cost, incremental QALYs, and incremental cost per QALY gained.
Between January and December of 2008, 226 patients who underwent transurethral resection of prostate (TURP) because of either AUR or lower urinary tract symptoms (LUTS) were included in the study.
AUR, moderate or severe LUTS (IPSS[+ or -]20) and low Qmax levels (<10 ml/s) were considered to be indications for prostatectomy.
AUR might determine that a service is not medically necessary and that therefore it should not be considered "eligible for payment.
These and other benefit-plan-dependent factors need to be taken into account in order to measure AUR program savings.
Given the need for linking data over weeks or months of service delivery, we decided that an AUR program needed to give review nurses and physicians access to relevant claims data, a database comprising tens of millions of records.
AUR Lesson #2: Episodes of Care Should Be Reviewed.
In August 2006, Northwestern Memorial Hospital began using TheraDoc technology to transmit the same AUR data to the CDC.
As this program is more broadly implemented, AUR reports from multiple hospitals across the country will enable nationwide surveillance of antimicrobial use and resistance and, ultimately, earlier interventions by the CDC on behalf of the American public.
Alfuzosin was recently approved in certain European countries for the related indication of AUR
, and is in late-stage clinical trials for a US filing for this indication.
The ALFAUR trial demonstrates that alfuzosin, through its action on risk factors and sympathetic overactivity, allows for rapid catheter removal in patients with AUR
and also significantly reduces the recurrence of AUR
and the need for BPH-related surgery in comparison with placebo in the medium term.