Elsevier

Urology

Volume 73, Issue 4, April 2009, Pages 743-746
Urology

Female Urology
Comparison of Economic Impact of Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Interstitial Cystitis/Painful Bladder Syndrome

https://doi.org/10.1016/j.urology.2008.11.007Get rights and content

Objectives

To perform a comparison of the economic impact of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and interstitial cystitis/painful bladder syndrome (IC/PBS) because limited information is available. Furthermore, no direct comparisons of the costs of these 2 conditions have been performed. Such a comparison is relevant because the distinction between the 2 conditions is not always clear.

Methods

We recruited 62 men with CP/CPPS and 43 women with IC/PBS from a tertiary care outpatient urology clinic. Information about hospitalizations, laboratory tests, physician visits, telephone calls, medication use, and lost productivity was obtained from written questionnaires. Direct medical cost estimates were determined from hospital cost accounting data, the 2005 Physician Fee Schedule Book, and the 2005 Redbook for pharmaceuticals. Indirect costs were determined from patient-reported annual income and patient-reported hours lost from work during the most recent 3-month period.

Results

Using Medicare rates, the annualized direct costs per person were $3631 for IC/PBS and $3017 for CP/CPPS. Using non-Medicare rates for outpatient visits and tests/procedures, the annual per person costs increased substantially to $7043 for IC/PBS and $6534 for CP/CPPS. Sixteen patients with CP/CPPS (26%) and 8 with IC/PBS (19%) reported lost wages as a result of their condition in the previous 3 months.

Conclusions

Both CP/CPPS and IC/PBS have very similar and substantial direct and indirect costs. The greater costs reflected by the non-Medicare rates may more accurately reflect the true costs, given that a large proportion of these patients were <65 years old.

Section snippets

Subjects

The sample consisted of 43 women and 62 men from the Northwestern University outpatient urology clinic. The patients were identified and recruited according to a physician diagnosis of IC/PBS for the women and CP/CPPS for the men. The patients were presented with a resource use questionnaire while waiting in the clinic or were mailed a questionnaire after being identified in the clinic setting. The institutional review board approved the study.

Questionnaire Content

The questionnaire included demographic information

Demographics

The demographic characteristics are listed in Table 1. The mean age of the male and female cohorts was identical (51 years). Most subjects were white and college educated. An annual household income >$50 000 was reported by 65% of the women and 73% of the men.

Use of Medical Services

A summary of outpatient visits and procedures related to IC/PBS and CP/CPPS for the preceding 3 months is provided in Table 2. Of the 43 women and 62 men, 30 (70%) and 45 (73%) reported ≥1 outpatient visit related to IC/PBS or CP/CPPS,

Comment

Approximately 80% of patients with either CP/CPPS or IC/PBS reported direct medical costs in the preceding 3 months that were attributed to their pelvic pain symptoms. The direct costs associated with IC/PBS were slightly greater than those for CP/CPPS across all examined categories. Using Medicare rates, the mean yearly cost for IC/PBS was $3631 per person and for CP/CPPS was $3017 per person. However, the use of non-Medicare rates might more accurately reflect the true costs, given that a

Conclusions

Both CP/CPPS and IC/PBS have substantial direct and indirect costs, with indirect costs accounting for a large proportion of the total. Regardless of the cost mechanism used (Medicare or non-Medicare), the direct costs of these conditions are greater than the mean yearly costs reported for many other chronic pain conditions. The substantial costs associated with CP/CPPS and IC/PBS support ongoing efforts to educate physicians about these conditions and to identify effective treatments.

References (13)

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This study was supported by National Institute of Diabetes and Digestive and Kidney Diseases grant U01 DK060177.

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