Opinion

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Geoffrey Sklar, MD, on considerations for implementing new therapies and tech in urology

Key Takeaways

  • New technologies in urology, such as drugs for bladder cancer, face challenges like high costs and limited insurance coverage.
  • Chesapeake Urology's advanced kidney stone program aims to expand its successful ambulatory percutaneous stone surgeries to other practices.
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“Particularly [in] bladder cancer, there's 2 new drugs on the market that are exceptionally expensive, but they do provide benefit to patients,” says Geoffrey N. Sklar, MD, FACS.

In this interview, Geoffrey N. Sklar, MD, FACS, recaps the session, “Incorporating New Tech & Treatments,” which was presented at the 2024 Stronger United Conference in Phoenix, Arizona. Sklar is the chief medical officer for Chesapeake Urology and United Urology Group.

Video Transcript:

That discussion was focused on 3 of our bigger service lines: bladder cancer, kidney stone disease, and overactive bladder. And how there are new technologies that are entering these fields and how to deploy that. In urology, we have a lot of toys. We have a lot of new drugs; we have a lot of new therapies. Just like any new shiny thing, there's downsides to all those things. Most of the downsides are cost. A lot of things that come out are not covered by insurance, they may cost an extravagant amount of money, but they do have patient value. The goal is, how do we get these therapies?

Particularly [in] bladder cancer, there's 2 new drugs on the market that are exceptionally expensive, but they do provide benefit to patients. That's what it's really all about. How do we get those new technologies, those new drugs, those new therapies to these patients without putting them financially at risk, without putting us financially at risk, and taking great care of patients. That's what we looked at there.

With kidney stones, we're one of the very few programs in the country where one of our affiliate group practices, Chesapeake, has an advanced kidney stone program for the treatment of large stones, where we're doing ambulatory percutaneous stone surgery. We're closing in on 5000 of these surgeries. We've done more than anybody else in the country, and we have our own fellowship. The goal of this was how do we spread that across our other group practices to give those patients that additional line of service to take better care of their kidney stones? And how do we unroll that so it looks similar to Maryland, but it's always different. That's one of the things that we have to be keenly aware of. Each of these environments, different types of patients, different obstacles, and different ways to deploy things. That's where we need the input from our docs, our APPs, and support staff.

The last group was the OAB, or female incontinence groups, where there's new technologies coming out where there are implantable devices to take away urgency incontinence. How do we deploy those, again, in a way where we don't put the patient at risk for a big bill, we don't lose money for ourselves, but we provide the services that keep them from getting additional or much more rigorous therapies. That was a really insightful discussion that we had. I think those discussions need to be had all the time when we're rolling out new technology and new devices.

This transcription has been edited for clarity.

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