|Urologic Diseases Cost Americans $11 Billion
Medicare Pays Half
Bladder, prostate and other urinary tract diseases cost Americans
nearly $11 billion a year, according to a new report from the National
Institutes of Health. Medicare’s share exceeded $5.4 billion.
The five most expensive urologic problems — accounting for
$9.1 billion — are, in descending order, urinary tract infections,
kidney stones, prostate and bladder cancers and benign prostate
enlargement, according to the authors of Urologic Diseases
in America. The report was published online this spring and
will be available in print and on CD in early May.
“This research sharply illustrates the immense burden of urologic
diseases and the importance of studies to preempt disease processes
and develop targeted treatments,” said Elias A. Zerhouni, M.D.,
Five years in the making, Urologic Diseases in America stitches
together a patchwork of reliable data, both new and previously
published, revealing numbers of people affected, treatment patterns
and economic cost.
|TOP DISEASES BY COST
Infection (Women & Men)
“The data have broad implications for quality of care and access
to care and helps to inform discussions about health care and research
needs,” said UDA coeditor Mark S. Litwin, M.D., M.P.H, a urologist
at the David Geffen School of Medicine and School of Public Health
at the University of California, Los Angeles.
Urologic Diseases in America describes more than a dozen
diseases of children and adults, among them congenital abnormalities,
erectile dysfunction, chronic prostatitis, interstitial cystitis,
urinary incontinence and a chapter on sexually transmitted diseases,
contributed by the Centers for Disease Control and Prevention.
- Medical care for nearly 12.8 million urinary tract
infections in women alone costs nearly $2.5 billion
annually. Adding the cost for men raises the total to $3.5
billion; Medicare’s share was $1.4 billion. Another $96.4 million
was spent on 3.3 million prescriptions. More than half of all
women will have an infection during their lifetimes. Reporting
a trend toward using newer, and more expensive, fluoroquinolones
raises concerns about increasing antibiotic resistance said
UDA authors. And while only 20 percent of infections are in
men, they are more often hospitalized and out of work about
twice as long as women.
- While hospitalizations, length of stay and the need for open
surgery are declining for kidney stones, medical
care still costs $2.1 billion annually, with another $4 million
to $14 million spent on prescription drugs. Men are two to three
times more likely than women to develop a stone, but more people
of all ages and races are getting them: an estimated 5 percent
of adults between 1988 and 1994, up from nearly 4 percent between
1976 and 1980. Compared to whites, African Americans and Mexican
Americans have a 70 percent and 35 percent lower risk, respectively,
of developing a stone.
- Although data for childhood urologic diseases are scarce, urinary
problems in children cost at least $75 million
dollars a year. Vesicoureteral reflux, the abnormal
flow of urine from the bladder up toward the kidneys, affects
about 10 percent of all children and makes them prone to urinary
tract infections and kidney damage. The cost of hospitalizations
for reflux alone rose from $10 million in 1997 to $47 million
in 2000; Southern states, defined using U.S. Census Bureau regions,
saw the highest rise — 56 percent — attributable
to a doubling in the number of cases.
“Our biggest challenge was finding reliable data in children,” said
Christopher Saigal, M.D., M.P.H., Litwin’s coeditor at UCLA and
RAND Health. “More research is needed in children.”
Urologic Diseases in America was funded by NIH’s National
Institute of Diabetes and Digestive and Kidney Diseases and developed
by a team of epidemiologists, health economists, statisticians,
programmers and urologists.
Learn more about urologic diseases at http://kidney.niddk.nih.gov;
click on statistics to find Urologic Diseases in America.
UDA books and CDs may be ordered from the National Kidney and Urologic
Diseases Information Clearinghouse at 1–800–891–5390, firstname.lastname@example.org and
The NIDDK, a component of the NIH, conducts and supports research
in diabetes and other endocrine and metabolic diseases; digestive
diseases, nutrition, and obesity; and kidney, urologic and hematologic
diseases. For more information about NIDDK and its programs, see www.niddk.nih.gov.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.