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• W2007473567 abstract "No AccessJournal of UrologyAdult Urology1 Aug 2011Cost-Effectiveness of Primary Prevention Strategies for Nephrolithiasis Yair Lotan and Margaret S. Pearle Yair LotanYair Lotan Financial interest and/or other relationship with Inverness and Abbott. More articles by this author and Margaret S. PearleMargaret S. Pearle Financial interest and/or other relationship with Cook Medical, Karl Storz Endoscopy, Omeros Corp. and Olympus Endoscopy. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.03.133AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Stone disease is a highly prevalent condition associated with substantial cost and morbidity. We evaluated the cost-effectiveness of a primary prevention strategy. Materials and Methods: A decision analysis model was constructed to compare the cost of ad hoc management of symptomatic stones vs the cost of primary prevention. A literature search was performed to determine the incidence of stone disease, the effectiveness of nonmedical prevention strategies and cost associated with stone management. One and 2-way sensitivity analyses were performed to determine conditions under which a strategy of primary prevention might be cost-effective. Results: Assuming a 1% incidence of stones, a 50% risk reduction and a $100 cost per individual per year for primary prevention, the model was used to calculate the overall costs per individual per year without and with a primary prevention strategy of $46 and $123, respectively. One-way sensitivity analyses indicated that primary prevention was cost-effective if the incidence of stones exceeded 4.3% yearly or the cost of prevention was less than $23 per person yearly. Varying other factors (risk reduction, probability of requiring surgery, hours of lost work, emergency room cost) failed to reach cost equivalence under any circumstances or required unrealistic assumptions. Preventive strategies were more costly than no prevention unless the incidence of stone disease was at least 1%, the cost did not exceed $20 per person per year and the prevention strategy was at least 50% effective in preventing stones. Conclusions: Primary prevention strategies for stone disease have not been sufficiently evaluated but can theoretically be cost-effective if the population has a sufficiently high incidence of stone disease and the strategy is of low cost and moderately effective. References 1 : Renal stone epidemiology: a 25-year study in Rochester, Minnesota. Kidney Int1979; 16: 624. Crossref, Medline, Google Scholar 2 : Frequency of urolithiasis in a prepaid medical care program. Am J Epidemiol1982; 115: 255. 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Google Scholar Department of Urology, the University of Texas Southwestern Medical Center, Dallas, Texas© 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byMasterson J, Jourdain V, Collard D, Choe C, Christman M, L'Esperance J and Auge B (2012) Changes in Urine Parameters After Desert Exposure: Assessment of Stone Risk in United States Marines Transiently Exposed to a Desert EnvironmentJournal of Urology, VOL. 189, NO. 1, (165-170), Online publication date: 1-Jan-2013. Volume 186Issue 2August 2011Page: 550-555 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordscalculicost-benefit analysisprimary preventionMetricsAuthor Information Yair Lotan Financial interest and/or other relationship with Inverness and Abbott. More articles by this author Margaret S. Pearle Financial interest and/or other relationship with Cook Medical, Karl Storz Endoscopy, Omeros Corp. and Olympus Endoscopy. More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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