Men's Preferences For The Treatment Of Lower Urinary Tract Symptoms (Luts) Associated With Benign Prostatic Hyperplasia (Bph): A Discrete Choice Experiment (Dce).

Abstract

To quantify men’s preferences and willingness to pay for attributes of medications to treat LUTS/BPH using a DCE. An online DCE was conducted with men in the UK aged ≥45 years with a self-reported International Prostate Symptom Score (IPSS) ≥8. Men were asked to consider different scenarios associated with moderate-to-severe LUTS, and then choose between two medical alternatives and a no-treatment option, according to seven attributes: day-time urinary frequency, night-time urinary frequency, urgency, sexual and non-sexual side effects, number of tablets/day and cost/month. These attributes were identified from a literature review and online discussion groups (ODGs). Men’s marginal willingness to pay (MWTP) and 95% confidence intervals for improvements in each attribute were calculated. Please see a separate meeting abstract for more information on the ODGs (Ikenwilo, et al). The DCE survey was conducted 19–26 March 2014.5212 individuals were invited to participate: 1097 opened the hyperlink, 586 were ineligible or excluded because the quota was full, and 247 completed the final survey used for this analysis. The mean age was 62.3 years and the mean IPSS was 15.7 (standard deviation 6.0). MWTP was £23.95/month and £25.42/month for an improvement from urge incontinence to moderate urgency or mild urgency, respectively; £5.80/month for one less night-time urination, and £1.30/month for one less day-time urination. Sexual side effects reduced MWTP by £29.70/month for erectile dysfunction, £18.37/month for "decreased sexual desire", and £16.92/month for "no fluid during ejaculation”. Non-sexual side effects reduced MWTP by £17.25/month for dizziness and £16.75/month for headaches. Neither dry mouth nor the number of tablets/day significantly affected MWTP. ConclusionsImproving urgency is perceived as the most important benefit of medication to men with LUTS/BPH; improving frequency is also valued. The perceived value of a medication is reduced by sexual and non-sexual side effects.