Letters

Drug treatment for benign prostatic hyperplasia

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7104.370b (Published 09 August 1997) Cite this as: BMJ 1997;315:370

Health authorities must audit use of finasteride

  1. Richard Mendelsohn, Specialist registrar in public health medicinea,
  2. Diane Thompson, Prescribing coordinatora
  1. a Directorate of Public Health and Health Policy, South Staffordshire Health Authority, Stafford ST16 3SR
  2. b Stepping Hill Hospital, Stockport SK2 7JE
  3. c Alexandra Hospital, Redditch B98 7UB

    Editor—Andrew Farmer and Jeremy Noble are right to draw attention to the results of a recent trial which showed that finasteride, a 5α-reductase inhibitor, was little better than placebo in a group of men with moderate symptoms of benign prostatic hyper- trophy.1 2 The mean prostatic volumes in this trial were in the range 36.2-38.4 cm3, which is lower than the volume in other, more positive, trials that have assessed the efficacy of finasteride.3

    Health authorities have a duty to ensure that prescribing is both clinically and cost effective.4 One can deduce, therefore, that the use of finasteride in men with moderate symptoms of benign prostatic hyperplasia and moderately enlarged prostates is neither. Moreover, expenditure on finasteride by health authorities is considerable. We have examined expenditure on and prescribing rates for finasteride in our district over the past two years, using the health authority …

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