Login to Access Video or Poster Abstract: MP09-10
Sources of Funding: This study was funded by Boehringer Ingelheim.

Introduction

Tamsulosin represented a breakthrough in the medical treatment of benign prostatic hyperplasia (BPH) due to its comparable efficacy and improved side effect profile over prior non-selective alpha 1-adrenoceptor blockers. Despite its ease of administration, prior studies suggest that urologists remain the gatekeepers for the medical management of BPH, providing higher dispensation of alpha- blockers than other medical specialties. With the changing healthcare landscape and off-label use of alpha-blockers for urolithiasis, prostatitis, and even female voiding dysfunction we evaluated current utilization trends and prescribing patterns associated with tamsulosin.

Methods

A retrospective analysis was performed using PharMetrics Plus, which processes pharmaceutical claims for 70 million patients from over 55 health plans in the United States. Patient and provider characteristics associated with dispensation of tamsulosin during an 18 month period between 2012 and 2013 were evaluated. Patients included in the analysis were continuously enrolled in the health plan for 12 months pre-index to 6 months post-index.

Results

During the period of this analysis 133,977 patients received dispensation for tamsulosin, 54.2% of whom were new users. Of the 72,583 new tamsulosin users, 59,197 (81.6%) were men and 13,386 (18.4%) were women. Interestingly, 59.2% (n=35,071) of these new male tamsulosin users did not receive a BPH diagnosis code at any time during the 18-month analysis period. Prescribing patterns, age, and comorbidities of patients initiating tamsulosin are summarized in the Table.

Conclusions

In this large cohort of privately insured patients, we have found some very interesting and unexpected prescribing trends for the selective alpha 1-adrenoceptor blocker, tamsulosin. Although it is FDA approved for the signs and symptoms of BPH, close to 20% of new prescriptions were for women suggesting off label uses have emerged, including management of urolithiasis, and other male and female voiding disorders. Furthermore, urologists are no longer the primary initiators of tamsulosin therapy, even for BPH. This has important implications for further research in order to fully understand the utilization of this class of pharmaceutical agents.

Funding

This study was funded by Boehringer Ingelheim.