The following is a summary of “Patient-Reported Financial Toxicity Associated With Management of Nephrolithiasis,” published in the APRIL 2023 issue of Urology by Setia, et al.
For a study, researchers sought to assess the financial burden related to nephrolithiasis in adults by using validated questionnaires for measuring financial toxicity.
A cross-sectional survey was conducted among adults with a history of nephrolithiasis in an outpatient clinic. The survey included the assessment of stone-related financial toxicity using the COST (Comprehensive Score for Financial Toxicity) score and gathering demographic information, stone event history, and the burden of overall, ancillary, preventative, and insurance costs. A COST score of ≤21 was considered indicative of high financial toxicity. Multivariable logistic regression was used to analyze the associations between demographic variables, stone event history, and financial toxicity.
A total of 100 patients completed the survey, with a median age of 57 (interquartile range, 48-64). The median COST score was 30 (interquartile range, 23-37), and 19% of the participants reported high financial toxicity. Univariable analysis revealed associations between financial toxicity and insurance status, household income, stone surgeries during a lifetime, and within the last 3 years (P < 0.05). The burden of costs was significantly higher in all categories among the high financial toxicity group (each P < 0.05). In the multivariable logistic regression analysis, only income >$75,000 remained significant in the second model (odds ratio: 0.22, 95% CI, 0.05-0.77, P = 0.02); however, this relationship did not persist in the final model. When asked about the provider’s consideration of their financial situation before making treatment recommendations, 39% of participants responded “quite a bit” or “very much.”
One out of five patients seeking care for nephrolithiasis experiences high financial toxicity. Financial toxicity was associated with household income, insurance status, education, and the frequency of stone events. A significant proportion of participants expressed the belief that their provider should be mindful of their financial situation when making treatment recommendations.