Alpha Blocker Medical Expulsive Therapy for Ureteral Stones—Usage of Health Care Resources

Abstract

Abstract Objective: To study the effects of alpha blocker prescription for ureteral stones on health care resources. Methods: In this retrospective study, patients with a new ureteral stone diagnosis were selected from a commercial claims database between 2011 and 2016. We examined data from patients who were and were not prescribed an alpha blocker for ureteral stone diagnosis. Comparative analyses were performed between these groups at 30 and 90 days postdiagnosis. We evaluated the need for surgical intervention, repeat imaging, emergency department (ED) visits, adverse events, and total medical claims cost. Results: Of 70,599 patients with ureteral stones, alpha blockers were prescribed to 51.1% for a median duration of ten days. At 30 and 90 days after index diagnosis, alpha blocker treated patients were more likely to undergo surgical intervention (P < .01, 1.06 HR), have additional imaging studies (P < .01, 1.37 HR), and visit the emergency department (P < .01, 1.19 HR). Total medical costs at 30 and 90 days were increased by 11.3% and 10.1%, respectively, for patients treated with an alpha blocker (P < .01). Conclusions: Patients who were prescribed an alpha blocker for a diagnosis of ureteral stone had increased surgical interventions, subsequent ED visits, additional imaging studies, and overall total cost to the health care system compared with patients not on alpha blockers. In addition to uncertain and disputed efficacy, the negative impact on health care resources should also be considered in the decision for the use of alpha blockers for ureteral stones.