Budget impact of incorporating one instillation of hexaminolevulinate hydrochloride blue‐light cytoscopy in transurethral bladder tumour resection for patients with non‐muscle‐invasive bladder cancer in Sweden

Abstract

ObjectivesTo explore the cost impact on Swedish healthcare of incorporating one instillation of hexaminolevulinate hydrochloride (HAL) blue-light cystoscopy into transurethral resection of bladder tumour (TURBT) in patients with suspected new or recurrent non-muscle-invasive bladder cancer (NMIBC). Materials and MethodsA decision tree model was built based on European Association of Urology guidelines for the treatment and management of NMIBC. Input data were compiled from two recent studies comparing recurrence rates of bladder cancer in patients undergoing TURBT with either the current standard of care (SOC) of white-light cystoscopy, or with the SOC and HAL blue-light cystoscopy. Using these published data with clinical cost data for surgical and outpatient procedures and pharmaceutical costs, the model reported on the clinical and economic differences associated with the two treatment options. ResultsThis model demonstrates the significant clinical benefits likely to be observed through the incorporation of HAL blue-light cystoscopy for TURBT in terms of reductions in recurrences of bladder cancer. Analysis of economic outputs of the model found that the use of one instillation of HAL for TURBT in all Swedish patients with NMIBC is likely to be cost-neutral or cost-saving over 5 years relative to the current SOC of white-light cystoscopy. ConclusionsThe results of this analysis provide additional health economic rationale for the incorporation of a single instillation of HAL blue-light cystoscopy for TURBT in the treatment of patients with NMIBC in Sweden.

Impact of enhanced optical techniques at time of transurethral resection of bladder tumour, with or without single immediate intravesical chemotherapy, on recurrence rate of non‐muscle‐invasive bladder cancer: a systematic review and network meta‐analysis of randomized trials

“…Cost‐effectiveness, in addition to clinical effectiveness, is an important factor in the uptake of new technologies. The use of a single‐instillation HAL for TURBT is cost‐neutral or cost‐saving in over 5 years, saving approximately €537 per patient in addition to its clinical benefits [ 36 , 37 .…”

The use of blue-light cystoscopy in the detection and surveillance of nonmuscle invasive bladder cancer

“…A similar cost analysis in Sweden found that incorporation of HAL into cystoscopy during TURBT would be cost-neutral or cost-saving over a 5-year period due to reduction in disease recurrence and progression. [ 34 ]…”

“…A similar cost analysis in Sweden found that incorporation of HAL into cystoscopy during TURBT would be costneutral or cost-saving over a 5-year period due to reduction in disease recurrence and progression. [34] A 2022 clinical and cost-effectiveness analysis examined the budget impact on practices that use BLFC for surveillance in the clinic setting. [32] They reported that over a 2-year period, BLFC identified 9 additional recurrences compared with WLFC alone, and use of BLFC increased cost by only $0.76 per cystoscopy.…”

<p>Humanistic and Economic Burden of Non-Muscle Invasive Bladder Cancer: Results of Two Systematic Literature Reviews</p>

“…85,86 In addition, three budget impact models (BIMs) and eighteen CEAs were identified from SLR searches, of which twelve evaluated TURBT, mainly comparing diagnostic imaging during the procedure as well as comparing TURBT to other procedures or procedure setting. [87][88][89][90][91][92][93][94][95][96][97][98] Two studies assessed intravesical therapy; 99,100 four assessed surveillance. [101][102][103][104] Four studies evaluated BCG and/or the impact of its shortage, [105][106][107][108] with one being a CEA that presented AE costs associated with BCG in high-risk patients.…”