THE FINANCIAL EFFECTS OF KIDNEY-STONE PREVENTION

Prevention of nephrolithiasis (NL) is now medically feasible and widel y recommended. However, diagnosis and treatment of remediable causes o f stones requires testing and drugs that impose a cost; this cost is b alanced by the presumed reductions in stone related events and medical encounters. In order to assess the balance between these, we have ana lyzed results from 1092 patients with NL unselected except for having clinical follow-up during treatment. From this population, we have der ived the changes in rates of new stones, hospitalizations, cystoscopie s, and surgical procedures. From these changes, and assignment of a ra nge of possible dollar costs, we estimate that medical stone preventio n will result in an average saving of $2,158 +/- $500 (SEM)/patient/ye ar, which is the difference between an expenditure of $1,068/patient o n yearly drugs and resting, and a reduction of $3,226 per patient in m edical costs. Medical prevention of NL seems justified on a cost savin g basis quite apart from its benefits to patients in terms of reduced morbidity and risk from procedures, obstruction, and infection.