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RESULTS: Compared to alpha-blocker alone, combination therapy was more expensive but more effective, resulting in a reduced risk of AURand surgery, and improved symptoms and quality of life. Cost-utility ratios ranged from 25, 985/ QALY for patients with PSA > 3. 2 ng/ml to 30, 698/QALY for all patients. Finasteride, although dominated by alpha-blocker therapy, may be cost-effective compared to watchful waiting in patients who fail alpha-blocker therapy and do not choose to proceed to surgery. Compared to watchful waiting, cost-utility ratios for finasteride ranged from 31, 709/QALY for patients with PSA > 3. 2ng/ml to 37, 308/QALY for all patients. The results were robust across a wide range of sensitivity analyses.
Hollenbeck et al. (Thu,) studied this question.