Recurrence Rate and Cost Consequence of the Shortage of Bacillus Calmette-Guérin Connaught Strain for Bladder Cancer Patients

Ourfali, S.; Ohannessian, Robin; Fassi-Fehri, H.; Pagès, A; Badet, Lionel; Colombel, M.

doi:10.1016/j.euf.2019.04.002

Cited by 50 publications

(33 citation statements)

References 26 publications

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“…Ourfali and coworkers estimated the clinical effect of BCG shortages between 2013 and 2016 in their unit of treatment. 24 They found a significantly higher rate of recurrence at 24 months after TURBT for current intermediate-and high-risk NMIBC patients than for their patients diagnosed and treated during the three years before the BCG shortage. Apart from patient care, clinical trials have been affected, and BCG shortages have even partially affected the immunization programs for TB prevention in children around the world.…”

Section: Clinical and Social Impact Of Bcg Shortagesmentioning

confidence: 94%

“…[25][26][27] From an economic point of view, Ourfali et al also found an increased cost due to the decrease in BCG production estimated at approximately €783 per patient with a new diagnosis of NMIBC during the period of restricted supply. 24 Moreover, the prices of chemotherapies used for BC therapy spiked dramatically during a 2014 BCG shortage. In fact, that year, the price of mitomycin jumped by almost 100%.…”

Section: Clinical and Social Impact Of Bcg Shortagesmentioning

confidence: 99%

See 1 more Smart Citation

<p>Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer: An Update</p>

Guallar-Garrido

Julián

2020

ITT

142

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Physicians treating patients affected by nonmuscle-invasive bladder cancer (NMIBC) have been in shock during the last six years since manufacturing restrictions on the production of the first-option medicine, Mycobacterium bovis Bacillus Calmette-Guérin (BCG), have resulted in worldwide shortages. This shortage of BCG has led to a rethinking of the established treatment guidelines for the rationing of the administration of BCG. Some possible schedule modifications consist of a decrease in the length of maintenance treatment, a reduction in the dose of BCG in intravesical instillations or the use of different BCG substrains. All these strategies have been considered valuable in times of BCG shortage. In addition, the lack of availability of BCG has also led to the general recognition of the need to find new treatment options for these patients so that they are not dependent on a single treatment. Few alternatives are committed to definitively replacing BCG intravesical instillations, but several options are being evaluated to improve its efficacy or to combine it with other chemotherapeutic or immunotherapeutic options that can also improve its effect. In this article, we review the current state of the treatment with BCG in terms of all of the aforementioned aspects.

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Section: Clinical and Social Impact Of Bcg Shortagesmentioning

confidence: 94%

Section: Clinical and Social Impact Of Bcg Shortagesmentioning

confidence: 99%

<p>Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer: An Update</p>

Guallar-Garrido

Julián

2020

ITT

142

View full text Add to dashboard Cite

show abstract

“…However, standard therapy is related to high tumour recurrence and progression rates, implying lifelong intensive monitoring and large healthcare costs [7]. As NMIBC incidence has increased in several European countries [8] and there is a BCG shortage related to the increased global demand [9][10][11], it is essential to search for new more effective therapeutic options or strategies to improve the efficacy of existing drugs.…”

Section: Introductionmentioning

confidence: 99%

Electro-mediated drug administration of mitomycin C in preventing non-muscle-invasive bladder cancer recurrence and progression after transurethral resection of the bladder tumour in intermediate- and high-risk patients

Carando

Soldini

Cotrufo

et al. 2020

Arab Journal of Urology

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“…Optimal dosing and treatment schedules for chemotherapeutic agents must preserve efficacy, minimize toxicity, and avoid wasting existing supply. In the realm of non-muscleinvasive bladder cancer (NMIBC), bacillus Calmette-Guérin (BCG) toxicity and global shortages have led urologic oncologists to confront this challenge head-on [4]. Never has it been more important to determine that "just right" dose to achieve equivalent oncologic outcomes with a lesser amount of drug (and ideally less toxicity).…”

mentioning

confidence: 99%

“…The goal of the EORTC 30962 trial was to minimize the adverse effects of BCG by reducing the BCG dose, and identified no significant differences in progression or survival for patients treated with a one-third dose compared to full-dose BCG. Not long after publication of the EORTC 30962 results, a global shortage of BCG had a widespread impact on bladder cancer, leading to increased recurrence rates and higher costs of care for patients with intermediate-and high-risk NMIBC [4].…”

mentioning

confidence: 99%