Skip to main content
Top
Published in: World Journal of Urology 3/2009

Open Access 01-06-2009 | Topic Paper

Economic aspects of bladder cancer: what are the benefits and costs?

Authors: K. D. Sievert, B. Amend, U. Nagele, D. Schilling, J. Bedke, M. Horstmann, J. Hennenlotter, S. Kruck, A. Stenzl

Published in: World Journal of Urology | Issue 3/2009

Login to get access

Abstract

Objective

Bladder cancer (BC) has the highest lifetime treatment costs per patient of all cancers. The high recurrence rate and ongoing invasive monitoring requirement are the key contributors to the economic and human toll of this disease. The purpose of this paper was to utilize the recent literature to identify opportunities for improving the benefits and costs of BC care.

Methods

A PubMed search was performed of recent publications concerning (BC) cost-effectiveness. We reviewed studies, reviews, opinion papers and cost-effectiveness analyses, focusing primarily on non-muscle-invasive bladder cancer (Ta/T1; NMIBC).

Results

New diagnostic tools such as urine markers may assist in more cost-effectively detecting BC at an earlier stage, however, these markers cannot replace the cystoscopy, which is the current standard of care. A photodynamic diagnostic tool (PDD) using hexylaminolevulinate (Hexvix®) enhances tumor visibility and improves transurethral resection of bladder cancer (TURB) results, potentially reducing recurrence rates and lowering treatment costs. While the importance of BC research has been acknowledged, research investment has been continuously reduced during the last 5 years.

Conclusions

The economic burden of BC is well-characterized in the literature. This study suggests that new technologies (i.e., urine-based tests, PDD) and therapeutic regimes (intravesical chemotherapy, adjuvant immunotherapy) have significant potential to improve the diagnosis, treatment and on-going monitoring of BC patients, with potential improvements in clinical outcomes and concurrent cost-savings. A renewed interest and investment in BC research are required to ensure future advancements.
Literature
1.
go back to reference Miller BA, Kolonel LN, Bernstein L et al (1996) Racial/ethnic patterns of cancer in the United States 1988–1992, National Cancer Institute. NIH Pub. No. 96-4104, Bethesda Miller BA, Kolonel LN, Bernstein L et al (1996) Racial/ethnic patterns of cancer in the United States 1988–1992, National Cancer Institute. NIH Pub. No. 96-4104, Bethesda
2.
go back to reference Ferlay J, Parkin DM, Pisani P (2001) GLOBOCAN 2000: cancer incidence, mortality and prevalence worldwide. IARC CancerBase No. 5. IARC Press, Lyon Ferlay J, Parkin DM, Pisani P (2001) GLOBOCAN 2000: cancer incidence, mortality and prevalence worldwide. IARC CancerBase No. 5. IARC Press, Lyon
10.
go back to reference Marchetti A, Wang L, Magar R et al (2000) Management of patients with Bacilli Calmette-Guerin-refractory carcinoma in situ of the urinary bladder: cost implications of a clinical trial for valrubicin. Clin Ther 22:422–438. doi:10.1016/S0149-2918(00)89011-6 PubMedCrossRef Marchetti A, Wang L, Magar R et al (2000) Management of patients with Bacilli Calmette-Guerin-refractory carcinoma in situ of the urinary bladder: cost implications of a clinical trial for valrubicin. Clin Ther 22:422–438. doi:10.​1016/​S0149-2918(00)89011-6 PubMedCrossRef
11.
go back to reference Stenzl A, Roessler W, Fradet Y et al (2009) Hexvix® fluorescence cystoscopy improves detection and resection of papillary bladder cancer and reduces early recurrence: a multicentre, prospective, randomized study. Abstract EAU Congress 2009 Stockholm Stenzl A, Roessler W, Fradet Y et al (2009) Hexvix® fluorescence cystoscopy improves detection and resection of papillary bladder cancer and reduces early recurrence: a multicentre, prospective, randomized study. Abstract EAU Congress 2009 Stockholm
13.
go back to reference Berookhim BM, Sethi AS, Wen CC et al (2008) A cost comparison of the diagnostic modalities used in the detection of urothelial carcinoma in patients undergoing evaluation for hematuria. UIJ 1 (in press). doi:10.3834/uij.1939-4810.2008.12.01 Berookhim BM, Sethi AS, Wen CC et al (2008) A cost comparison of the diagnostic modalities used in the detection of urothelial carcinoma in patients undergoing evaluation for hematuria. UIJ 1 (in press). doi:10.​3834/​uij.​1939-4810.​2008.​12.​01
18.
20.
21.
go back to reference Denzinger S, Burger M, Walter B et al (2007) Clinically relevant reduction in risk of recurrence of superficial bladder cancer using 5-aminolevulinic acid-induced fluorescence diagnosis: 8-year results of prospective randomized study. Urology 69:675–679. doi:10.1016/j.urology.2006.12.023 PubMedCrossRef Denzinger S, Burger M, Walter B et al (2007) Clinically relevant reduction in risk of recurrence of superficial bladder cancer using 5-aminolevulinic acid-induced fluorescence diagnosis: 8-year results of prospective randomized study. Urology 69:675–679. doi:10.​1016/​j.​urology.​2006.​12.​023 PubMedCrossRef
22.
go back to reference Kruck S, Horstmann M, Hennenlotter J, et al (2009) Virtual transurethral bladder resection training for urologists. Abstract AUA Meeting Chicago Kruck S, Horstmann M, Hennenlotter J, et al (2009) Virtual transurethral bladder resection training for urologists. Abstract AUA Meeting Chicago
25.
go back to reference Sylvester RJ, Oosterlinck W, van der Meijden AP (2004) A single immediate postoperative instillation of chemotherapy decreases the risk of recurrence in patients with stage Ta T1 bladder cancer: a meta-analysis of published results of randomized clinical trials. J Urol 171:2186–2190. doi:10.1097/01.ju.0000125486.92260.b2 quiz 2435PubMedCrossRef Sylvester RJ, Oosterlinck W, van der Meijden AP (2004) A single immediate postoperative instillation of chemotherapy decreases the risk of recurrence in patients with stage Ta T1 bladder cancer: a meta-analysis of published results of randomized clinical trials. J Urol 171:2186–2190. doi:10.​1097/​01.​ju.​0000125486.​92260.​b2 quiz 2435PubMedCrossRef
26.
28.
31.
go back to reference Kilbridge KL, Kantoff PW, Loughlin KR (1997) Is bacillus calmette-guerin (BCG) immunotherapy cost-effective in recurrent high grade transitional cell cancer (TCC)? J Urol 157(4) (Suppl):214. Abstract Kilbridge KL, Kantoff PW, Loughlin KR (1997) Is bacillus calmette-guerin (BCG) immunotherapy cost-effective in recurrent high grade transitional cell cancer (TCC)? J Urol 157(4) (Suppl):214. Abstract
32.
go back to reference Smith JA Jr, Labasky RF, Cockett AT et al (1999) Bladder cancer clinical guidelines panel summary report on the management of nonmuscle invasive bladder cancer (stages Ta, T1 and TIS). The American Urological Association. J Urol 162:1697–1701. doi:10.1016/S0022-5347(05)68208-0 PubMedCrossRef Smith JA Jr, Labasky RF, Cockett AT et al (1999) Bladder cancer clinical guidelines panel summary report on the management of nonmuscle invasive bladder cancer (stages Ta, T1 and TIS). The American Urological Association. J Urol 162:1697–1701. doi:10.​1016/​S0022-5347(05)68208-0 PubMedCrossRef
37.
go back to reference USA Today/Kaiser Family Foundation/Harvard School of Public Health Health Care Costs Survey Summary and Chartpack (publication No. 7371) (2005) The Henry J. Kaiser Family Foundation, Menlo Park (CA). Available at: http://www.kff.org/newsmedia/7371.cfm. Accessed 20 March 2007 USA Today/Kaiser Family Foundation/Harvard School of Public Health Health Care Costs Survey Summary and Chartpack (publication No. 7371) (2005) The Henry J. Kaiser Family Foundation, Menlo Park (CA). Available at: http://​www.​kff.​org/​newsmedia/​7371.​cfm.​ Accessed 20 March 2007
38.
go back to reference Yabroff KR, Davis WW, Lamont EB et al (2007) Patient time costs associated with cancer care. J Natl Cancer Inst 99:14–23PubMedCrossRef Yabroff KR, Davis WW, Lamont EB et al (2007) Patient time costs associated with cancer care. J Natl Cancer Inst 99:14–23PubMedCrossRef
39.
go back to reference The estimated NCI investment is based on funding associated with a broad range of peer-reviewed scientific activities. For additional information on research planning and budgeting at the National Institutes of Health. Available at: http://www.nih.gov/about/ The estimated NCI investment is based on funding associated with a broad range of peer-reviewed scientific activities. For additional information on research planning and budgeting at the National Institutes of Health. Available at: http://​www.​nih.​gov/​about/​
Metadata
Title
Economic aspects of bladder cancer: what are the benefits and costs?
Authors
K. D. Sievert
B. Amend
U. Nagele
D. Schilling
J. Bedke
M. Horstmann
J. Hennenlotter
S. Kruck
A. Stenzl
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
World Journal of Urology / Issue 3/2009
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-009-0395-z

Other articles of this Issue 3/2009

World Journal of Urology 3/2009 Go to the issue