Prescription Trends of Initial Pharmacotherapy for Benign Prostatic Hyperplasia Among Treatment‐Naïve Patients in South Korea: A Retrospective Analysis

Background Benign prostatic hyperplasia (BPH) is a common urological condition in aging men that causes lower urinary tract symptoms. Pharmacotherapy is central to BPH management; however, considering updated guidelines, recent prescription trends remain insufficiently explored. This study aimed to assess initial pharmacotherapy trends in patients newly diagnosed with BPH. Methods This cross‐sectional analysis used 2015–2020 data from the Health Insurance Review and Assessment Service to examine the trends and influencing factors of BPH drug utilization among South Korean patients aged ≥ 40 years with no prior history of BPH. Subgroup analyses were performed by categorizing patients into five age groups (40–49, 50–59, 60–69, 70–79, and ≥ 80 years) to evaluate age‐specific prescription patterns. Results Of the 1,445,144 patients newly diagnosed with BPH, 1,336,695 (92.4%) initiated treatment within 60 days of diagnosis. Among those treated, 54.9% received α‐blocker (AB) monotherapy and 17.9% received 5α‐reductase inhibitor (5‐ARI)/AB combinations. Use of 5‐ARI/AB combinations increased with age, from 8.0% in patients in their 40s to 25.4% in those aged ≥ 80 years. Tamsulosin (a selective AB), dutasteride (a 5‐ARI), and mirabegron (a β3‐agonist) were the most frequently prescribed agents. Conclusion Recent American Urological Association (AUA) guidelines recommend combination therapy as an effective strategy for reducing the risk of BPH‐related complications. Although the largest proportion of patients was prescribed AB monotherapy, the growing adoption of combination therapy in South Korea, particularly among older age groups, suggests a shift toward more guideline‐concordant and effective therapeutic approaches.