When is Medical Prophylaxis Cost-effective for Recurrent Calcium Stones?

No AccessJournal of UrologyCLINICAL UROLOGY: ORIGINAL ARTICLES1 Sep 2002When is Medical Prophylaxis Cost-effective for Recurrent Calcium Stones? Paramjit S. Chandhoke Paramjit S. ChandhokeParamjit S. Chandhoke View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64546-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Medical management is generally recommended for recurrent calcium stones to prevent future episodes. However, in this era of extracorporeal shock wave lithotripsy and outpatient ureteroscopy it is not known whether medical prophylaxis is more cost-effective than treatment of recurrent stone episodes. The cost of medical prophylaxis was compared with the cost of clinically managing recurrent stone episodes, and the stone recurrence rate without prophylaxis (stone frequency) at which these 2 treatment approaches became cost equivalent was determined. Materials and Methods: An international cost survey was conducted in 10 countries to compare costs of medical prophylaxis and managing recurrent acute stone episodes. Costs of an acute stone episode included an emergency room visit, associated radiographic imaging to confirm diagnosis of a symptomatic stone and outpatient treatment of upper urinary tract stones that did not pass spontaneously. Costs of medical management included an initial limited metabolic evaluation, drug therapy, a followup office visit every 6 months that included a 24-hour urinalysis and radiographic imaging of the kidneys, ureters and bladder once a year. Results: Costs of medical prophylaxis and managing an acute stone episode varied significantly from country to country. The stone frequency at which costs of these management options became equivalent ranged from 0.3 to 4 stone episodes a year. Conclusions: Medical management of a first stone episode is not cost-effective. 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Google Scholar From the Departments of Surgery (Urology) and Medicine (Renal Diseases), University of Colorado Health Sciences Center, Denver, Colorado© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByPatel P, Koehne E, Chen V, Nelson M, Baker M, Gupta G and Baldea K (2020) Initial Extracorporeal Shockwave Lithotripsy versus Ureteroscopy: A Re-treatment and Cost Analysis Using a Longitudinal, Population-Based DatabaseUrology Practice, VOL. 8, NO. 2, (203-208), Online publication date: 1-Mar-2021.Lotan Y and Pearle M (2011) Cost-Effectiveness of Primary Prevention Strategies for NephrolithiasisJournal of Urology, VOL. 186, NO. 2, (550-555), Online publication date: 1-Aug-2011.LOTAN Y, CADEDDU J, ROERHBORN C, PAK C and PEARLE M (2018) COST-EFFECTIVENESS OF MEDICAL MANAGEMENT STRATEGIES FOR NEPHROLITHIASISJournal of Urology, VOL. 172, NO. 6 Part 1, (2275-2281), Online publication date: 1-Dec-2004.LEE Y, HUANG W, LU C, TSAI J and HUANG J (2018) Stone Recurrence Predictive Score (SRPS) for Patients with Calcium Oxalate StonesJournal of Urology, VOL. 170, NO. 2, (404-407), Online publication date: 1-Aug-2003. Volume 168Issue 3September 2002Page: 937-940 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordscosts and cost analysisrecurrenceurinary calculiMetricsAuthor Information Paramjit S. Chandhoke More articles by this author Expand All Advertisement PDF DownloadLoading ...