[Cost-effectiveness analysis of preventive treatment of urinary lithiasis recurrence using potassium citrate]

Author(s): Gisbert Gelonch R, Fernandez Augusto L

Affiliation(s): SOIKOS, Centre d'Estudis en Economia de la Salut i de la Politica Social, S. L. Barcelona, Espana.

Publication date & source: 1997-05, Arch Esp Urol., 50(4):373-80.

Publication type: Review

OBJECTIVE: This study evaluated two possible alternatives of potassium citrate administration-granulate (liquid) and tablet (wax matrix)-versus treatment with diet and/or fluid to prevent recurrence of urinary lithiasis. METHODS: The cost-effectiveness of the alternative modalities were analyzed using data from the studies conducted by Barcelo (1993), Pak (1985) and Preminger (1985). The variables utilized for effectiveness were 'avoided relapse' and 'avoided intervention'. Since the data from the foregoing studies did not make any distinction between the two alternative forms of potassium citrate administration, the incidence of side effects and the dropout rate were included. These data were obtained from the studies conducted by Barcelo (1993). Campoy (1994) and Conte (1994). RESULTS/CONCLUSION: Potassium citrate is effective in the prevention of recurrence of urinary lithiasis; relapses and interventions were significantly avoided. Both forms of potassium citrate are similarly effective and the only differences found were in regard to the side effects and the dropout rate; however, further studies are warranted to determine the possible differences with more precision. Potassium citrate in granulated form in much more cost-effective than the diet and fluid regimen than the tablet alternative, with a difference significantly in favor of the former in the order of 8:1. Price was the most important variable and therefore it is important to determine the appropriate dosage since it will influence the cost-effectiveness ratio and the allocation of resources.