The following is the summary of “Financial Toxicity of Nephrolithiasis: The First Assessment of the Economic Stresses of Kidney Stone Treatment” published in the December 2022 issue of Urology by Green, et al. 

The purpose of this study is to examine the financial toxicity (FT) of kidney stone treatment. Researchers conducted cohort research that included stone-makers from various institutions, both physically and virtually. COST, a tried and true participant survey instrument, was used (Comprehensive Score for financial Toxicity). With a maximum possible score of 44, lesser scores denote better FT. COST scores between 25 and 14 were considered “moderate FT,” while values below 14 were considered “severe FT.” SPSS v28 was utilized for all of the descriptive statistics, X2 tests, T-tests, Spearman correlation, and logistic regression analyses.

A total of 241 people (126 in-person and 115 online) were polled for this study. 60 % reported having at least moderate FT (COST score <26), and 26% had severe FT (COST score <14). Patients who had moderate-to-severe FT were younger than those with low FT by a median of 8 years (95%CI =4, 12). Out-of-pocket costs were found to negatively correlate with COST scores (Spearman’s rho=-0.406, P=<.001). In addition, it was shown that both participants with moderate to severe FT and their carers missed significantly more work days because of their stone condition (P=.002).

There was widespread moderate to severe FT throughout the sample. Since moderate FT patients have been documented to use cost-coping techniques (i.e., drug rationing) and severe FT patients, have worse health outcomes, urologists treating kidney stone patients need to be aware of the financial difficulties their patients may face.