studies. The projected cost savings was then utilized to predict costeffectiveness of the Moses technology utilizing $358.16 as the price differential between a Moses laser fiber and a Boston Scientific TracTip fiber (list price $919 vs. $560.84), $39,900 as the price differential for Moses software amortized over 1000 procedures, and $100 as the cost per minute billed to insurance for our ureteroscopy procedures.RESULTS: 40 patients underwent ureteroscopy with laser lithotripsy for kidney or ureteral stones. The mean lasing time was 3.02 minutes (mins) and median time was 1.43 mins. Mean stone size was 10.2 mm (range 6 to 16 mm). Linear regression showed a positive association between stone size and laser time, p¼0.01. The average lasing time for stones > 10mm was 4.14 mins versus 1.60 mins for stones 10 mm (p ¼ 0.03) with an estimate effect of 2.91 min. There was no significant effect of stone composition (CAOX vs. CAPH, p¼ 0.10) or HU (> 1000 HU or < 1000 HU, p ¼ 0.31) on laser time. Cost analyses suggested the Moses technology would save 52 seconds of lasing time, or $87.30 per case, for stones larger than 10 mm. With a differential in fiber/software cost of $398.06, the Moses technology would overall increase the cost of procedure for larger stones $310.76. The cost differential would be further increased for stones smaller than 10 mm.CONCLUSIONS: The decrease in lasing time achieved by the Moses system does not translate into sufficient cost savings to off-set the higher cost of the laser fiber and software. If a reduction in total procedure time of 4 minutes or greater were accomplished due to decreased stone retropulsion a cost savings could be realized.
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