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ORIGINAL ARTICLE
Year : 2019  |  Volume : 30  |  Issue : 3  |  Page : 131-135

Consensus report on controversial use of 5-alpha-reductase inhibitor in patients with benign prostatic hyperplasia under Taiwan National Health Insurance Regulations


1 Department of Urology, College of Medicine, En Chu Kong Hospital, New Taipei City, Taiwan
2 Department of Urology, College of Medicine, En Chu Kong Hospital, New Taipei City; Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan City, Taiwan

Correspondence Address:
Ming-Hong Kao
Department of Urology, College of Medicine, En Chu Kong Hospital, San-Shia District, New Taipei City
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/UROS.UROS_150_18

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Introduction: Although the National Health Insurance regulations for 5-alpha-reductase inhibitor (5ARI) use is well documented, urologists and medical claims review committee members have sometimes felt confused when determining claims for 5ARI use in certain circumstances. Thus, a consensus meeting was held to discuss how to use 5ARI appropriately in such circumstances. Materials and Methods: The expert urologists and medical claim review committee members reviewed seven controversial cases with related clinical evidence and voted for approval of the use of 5ARI after vigorous discussion. Results: Among the seven cases, a consensus was achieved in four. First, transrectal ultrasound of the prostate was not necessary if the patient already had other images. Second, prescribing 5ARI was affirmed in patients who had high prostate-specific antigen but who refused biopsy. Third, the normal prostate-specific antigen range was based on the 2003 version of the consensus of prostatic cancer of the National Health Research Institutes. Four, 5ARI could be prescribed in patients with improved clinical data but who were unable to meet the other regulatory criteria. Finally, of the three remaining cases, one case was denied, and in two cases, half of the members approved, and half rejected the claim for 5ARI use. Conclusion: This consensus report provided clarification for Taiwanese urologists and medical claims review committee members on reimbursable use of 5ARI in controversial cases.


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