Comparing extracorporeal shock wave lithotripsy and ureteroscopy laser lithotripsy for treatment of urinary stones smaller than 2 cm: a cost-utility analysis in the Spanish clinical setting
- 22 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in World Journal of Urology
- Vol. 39 (9), 3593-3598
- https://doi.org/10.1007/s00345-021-03620-w
Abstract
Purpose To analyze the efficiency and cost-utility profile of ureteroscopy versus shock wave lithotripsy for treatment of reno-ureteral stones smaller than 2 cm. Methods Patients treated for urinary stones smaller than 2 cm were included in this study (n = 750) and divided into two groups based on technique of treatment. To assess the cost-utility profile a sample of 48 patients (50% of each group) was evaluated. Quality of life survey (Euroqol 5QD-3L) before–after treatment was applied, Markov model was designed to calculate quality of life in each status of the patients (stone or stone-free with and without double-J stent) and to estimate the incremental cost-utility. Monte carlo simulation was conducted for a probabilistic sensitivity analysis. Chi-square was used for comparing qualitative variables and T student’s for continuous variables. Results Shock wave lithotripsy group had 408 (54.4%) and ureteroscopy group had 342 (45.6%) patients. Of them, 56.3% were treated for renal stones and 43.7% for ureteral stones. Ureteroscopy produced slightly higher overall quality of patients’ life, but produced a significant higher overall cost per quality-adjusted life year (QALY) than shock wave lithotripsy, exceeding the cost-utility threshold (20,000€/QALY). Sensitivity analysis confirmed results in 93.65% of cases. Difference was maintained in subgroup analysis (ureteral vs renal stones). Conclusions Results suggest that in our clinical setting shock wave lithotripsy has better cost-utility profile than ureteroscopy for treatment of reno-ureteral stones less than 2 cm, but excluding waiting times, in ideal clinical setting, ureteroscopy would have better cost-utility profile than shock wave lithotripsy.Keywords
This publication has 23 references indexed in Scilit:
- Economic Outcomes of Treatment for Ureteral and Renal Stones: A Systematic Literature ReviewJournal of Urology, 2012
- Study of quality of life and its determinants in patients after urinary stone fragmentationHealth and Quality of Life Outcomes, 2010
- Determinants of Quality of Life for Patients With Kidney StonesJournal of Urology, 2008
- The NICE Cost-Effectiveness ThresholdPharmacoEconomics, 2008
- Estudio de factores físico-químicos en pacientes con litiasis renalArchivos Espanoles de Urologia, 2006
- Health-related quality of life associated with chronic conditions in eight countries: Results from the International Quality of Life Assessment (IQOLA) ProjectQuality of Life Research, 2004
- EuroQol: the current state of playHealth Policy, 1996
- Clinical Implications of Clinically Insignificant Stone Fragments After Extracorporeal Shock Wave LithotripsyJournal of Urology, 1996
- Economic evaluation and health care. What does it mean?BMJ, 1993
- EuroQol - a new facility for the measurement of health-related quality of lifeHealth Policy, 1990