REAL-WORLD HEALTHCARE COSTS AND RESOURCE UTILIZATION ASSOCIATED WITH PACLITAXEL-COATED BALLOON VS. URETHROPLASTY FOR URETHRAL STRICTURE: A US CLAIMS ANALYSIS
Author(s)
Karl Coutinho, MD1, Stephen Grow, BS2, Chaitanya Badwe, Ph D2, Vallish BN, MD3, Craig Patrick, BS4, Jayant Suppal, MS5.
1East Coast Advanced Urology, Clifton, NJ, USA, 2Definitive Healthcare, Framingham, MA, USA, 3MarksMan Healthcare Communications Pvt Ltd, Hyderabad, India, 4Laborie Medical Technologies, Minneapolis, MN, USA, 5Laborie Medical Technologies, London, United Kingdom.
1East Coast Advanced Urology, Clifton, NJ, USA, 2Definitive Healthcare, Framingham, MA, USA, 3MarksMan Healthcare Communications Pvt Ltd, Hyderabad, India, 4Laborie Medical Technologies, Minneapolis, MN, USA, 5Laborie Medical Technologies, London, United Kingdom.
OBJECTIVES: To compare direct costs and healthcare resource utilization (HCRU) between urethral stricture patients treated with paclitaxel-coated balloon (PCB) and those treated with urethroplasty in a large US payor claims database.
METHODS: Retrospective cohort analysis of US healthcare claims (2021-2025) identified stricture patients treated with PCB (n=1,944) or urethroplasty (n=1,209). A 1:1 propensity-matched cohort of 627 pairs was constructed on age, sex, geographic variables, index year, and Charlson Comorbidity Index. Costs and HCRU were assessed across two timeframes: stricture diagnosis through one-year post-procedure (TF1, pre-intervention metrics annualized for variation in time to intervention) and the post-procedure year alone (TF2). Adjusted cost ratios and incidence rate ratios (IRR) with 95% CIs were estimated using multivariable regression adjusted for pre-index HCRU and patient characteristics.
RESULTS: Total adjusted costs in TF1 were 35% lower for PCB ($118,453 vs. $182,043; cost ratio 0.65 [95% CI 0.56-0.75], p<0.001); all cost subcategories (inpatient hospitalization, ED, specialty, and urologist costs) were also significantly lower (cost ratios 0.47-0.77, p≤0.038). Excluding the intervention date cost, savings remained significant; all cost subcategories favored PCB (cost ratios 0.45-0.78, p≤0.049). In TF2, total costs including subsequent procedures were 31% lower for PCB ($61,535 vs. $89,359; cost ratio 0.69 [0.60-0.79], p<0.001); all cost subcategories favored PCB, with hospitalization and urologist costs significantly lower. Excluding subsequent procedure costs, all cost metrics remained lower for PCB though urologist costs reached significance (cost ratio 0.50 [0.38-0.65], p<0.001). In TF1, PCB patients had significantly lower HCRU across all six outcomes (IRRs 0.60-0.86, all p<0.001); in TF2, HCRU differences attenuated, with only inpatient length of stay remaining significant (IRR 0.75 [0.60-0.94], p=0.013).
CONCLUSIONS: PCB was associated with lower direct healthcare costs vs. urethroplasty across the full stricture management period, with savings spanning all cost subcategories and persisting after exclusion of intervention date cost, supporting PCB as a cost-efficient treatment for urethral strictures.
METHODS: Retrospective cohort analysis of US healthcare claims (2021-2025) identified stricture patients treated with PCB (n=1,944) or urethroplasty (n=1,209). A 1:1 propensity-matched cohort of 627 pairs was constructed on age, sex, geographic variables, index year, and Charlson Comorbidity Index. Costs and HCRU were assessed across two timeframes: stricture diagnosis through one-year post-procedure (TF1, pre-intervention metrics annualized for variation in time to intervention) and the post-procedure year alone (TF2). Adjusted cost ratios and incidence rate ratios (IRR) with 95% CIs were estimated using multivariable regression adjusted for pre-index HCRU and patient characteristics.
RESULTS: Total adjusted costs in TF1 were 35% lower for PCB ($118,453 vs. $182,043; cost ratio 0.65 [95% CI 0.56-0.75], p<0.001); all cost subcategories (inpatient hospitalization, ED, specialty, and urologist costs) were also significantly lower (cost ratios 0.47-0.77, p≤0.038). Excluding the intervention date cost, savings remained significant; all cost subcategories favored PCB (cost ratios 0.45-0.78, p≤0.049). In TF2, total costs including subsequent procedures were 31% lower for PCB ($61,535 vs. $89,359; cost ratio 0.69 [0.60-0.79], p<0.001); all cost subcategories favored PCB, with hospitalization and urologist costs significantly lower. Excluding subsequent procedure costs, all cost metrics remained lower for PCB though urologist costs reached significance (cost ratio 0.50 [0.38-0.65], p<0.001). In TF1, PCB patients had significantly lower HCRU across all six outcomes (IRRs 0.60-0.86, all p<0.001); in TF2, HCRU differences attenuated, with only inpatient length of stay remaining significant (IRR 0.75 [0.60-0.94], p=0.013).
CONCLUSIONS: PCB was associated with lower direct healthcare costs vs. urethroplasty across the full stricture management period, with savings spanning all cost subcategories and persisting after exclusion of intervention date cost, supporting PCB as a cost-efficient treatment for urethral strictures.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD72
Topic
Economic Evaluation, Medical Technologies, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Surgery, Urinary/Kidney Disorders