Combination of Tadalafil and Finasteride for the Treatment of Urinary Tract Symptoms Related to Benign Prostatic Hyperplasia: Commercialization of the Prescribing Cascade

An oral capsule combining finasteride and tadalafil was recently approved in the USA for signs and symptoms of benign prostatic hyperplasia (BPH). The authors argue that this new formulation has a limited role in the management of BPH and represents an avoidable prescribing cascade and low-value care. There is an armamentarium of medical and surgical alternatives that should be considered instead of a tadalafil and finasteride combination therapy given the problem of increasing polypharmacy and considerations for value-based care.