PP-125 Cost-savings by using Memokath 051 for malignant ureteric obstruction - A single centre experience in the UK

Introduction: The Memokath 051 is a semipermanent segmental metal alloy stent which sits across the stricture, does not need exchanges, cause less bladder irritation and is more resistant to external compression pressure. The relatively high price of the Memokath 051 has been seen as a drawback. We present here a cost-comparison model between Double J stent and Memokath 051. On the basis of that model we showed cost-savings from our experience with Memokath 051 for malignant ureteric obstruction. The Model and Methods: A JJ stent including all costs (material, hospital services, theatre, recovery etc) comes to around €3000. Assuming 6 monthly stent exchanges and two outpatient follow-ups with X-ray per year, the total cost is around €6600/year. Insertion of Memokath 051 requires the same infra-structure. Additional costs arise from the stent itself which is around €2300. Together with three follow up visits in the first year with X-rays the total cost is around €5700. 41Memokath 051 were inserted in 37 patients with malignant ureteric stricture. Mean follow-up – 22 months. Stent blockage and migration rates were 4.7% and 11.7% respectively which required replacement. Results: Using the Model, in the first year, the Memokath 051 is €900 less expensive than the treatment with regular exchanges of JJ stent. However, from second year Memokath 051 patients will only require two per yearly follow up with X-ray at around €600. Therefore, from second year, the annual saving through Memokath 051 is around €6000. For six monthly exchange of 41 JJ stents in 37 patients for a 22 month period of time would have cost €490,200 whereas Memokath 051 costed €282,200 together with replacement for blocked (2 stents) and migrated stents (5 stents). Total cost-savings with Memokath 051 is €208,000. Conclusion: Memokath 051 is cost-effective as compared to JJ stent for extrinsic malignant ureteric stricture.