TRENDS IN ALPHA-BLOCKER TREATMENT OF PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA AND HYPERTENSION - DOSING REGIMENS AND COST COMPARISONS

Dosing regimen is an important determinant of both drug cost and patie nt compliance. This retrospective analysis evaluated dosing regimens a nd drug acquisition costs for 101 patients identified from medical rec ords in a large metropolitan hospital as having hypertension and/or be nign prostatic hyperplasia and receiving alpha-blocker therapy with ei ther doxazosin or terazosin. Although once-daily administration is gen erally recommended for both drugs, 25 (38%) of 66 patients receiving t erazosin were treated twice daily compared with 6 (17%) of 35 patients treated twice daily with doxazosin. This difference was statistically significant. The average (mean +/- SD) daily treatment cost per patie nt for all individuals receiving terazosin during the period of the re cord review was $1.68 +/- 0.60. For patients treated with doxazosin, t he average was $0.96 +/- 0.65-a highly statistically significant resul t. If all 66 patients receiving terazosin had been converted to doxazo sin at the beginning of the study, annual savings would have been $17, 345.00. These results demonstrate the importance of reviewing actual d osing regimens. The fact that doxazosin could be administered to a sig nificantly higher percentage of patients once daily rather than twice daily substantially decreased its cost relative to terazosin. A once-d aily treatment regimen may also enhance patient compliance, thereby im proving the chances of therapeutic success.