Stage-Related Cost of Treatment of Bladder Cancer in Brazil

Abstract

Purpose Bladder cancer is the ninth most frequent cancer worldwide with the twelfth highest incidence. However, its treatment has financial impacts that directly affect health burden. There is a scarcity of data about the costs related to healthcare in Brazil, especially in the public setting. As previously demonstrated, despite not being one of the most frequent cancers, bladder cancer appears to be one of the most expensive. The present study aimed to assess the costs related to the treatment of bladder cancer in the public setting in Brazil. Patients and Methods Retrospective data of patients treated for urothelial bladder carcinoma from 2019 to 2020 were retrieved at a single center. All charts were reviewed, with the assessment of clinical data, exams, surgical data, and postprocedure outcomes. The hospital finance department calculated the costs for outpatient evaluation, inpatient procedures, complementary exams, materials, drugs, and professionals' fees throughout all operations. Results A total of 107 patients with bladder cancer were analyzed, representing a total expenditure of BRL 5,671,042.70 and a mean cost of BRL 53,000.04 per patient (US$1.00 = BRL 5.60). Median costs were progressively higher for patients with stages I, II, III, and IV. Patients who underwent radical cystectomy (n = 14) had a median treatment cost of BRL 136,606.25 ± 96,059.08, during a mean follow-up of 9.2 months. Hospitalization costs represented 25% (range 20-43% according to the stage) of all expenditure. Medications and medical supplies represented 18% (16-23% according to the stage) of expenditure. Medical fees represented 31% of costs for stage I disease, but only 4% in stage II, III, and IV. Costs associated with emergency room visits were only observed in stage III and IV disease, representing 1% of all expenditure. Conclusions The management of bladder cancer resulted in a significant economic burden on our public health system. The costs associated with stage I bladder cancer were 4-12 times higher than those related to the treatment of other common malignancies at initial stages. Treatment was also expensive during the first months with more advanced stages.

Lawsuits against the Brazilian Unified Health System regarding Bladder/Ureteral Cancer

“…However, these improvements come at high costs, and they are adding a substantial economic burden to the health system. 13,14 The SUS is a universal health system, and health care is a constitutional legal right in Brazil. The three branches of power of the Brazilian government work to balance these rights.…”

“…These lawsuits are normally associated with a high Bladder cancer is already known to be an expensive disease. 14,17 The increasing number of cases in the last decade in Brazil, 16 along with the increment in costs with new drugs, bring huge concerns to the economic viability of the system.…”

“…This is even more important given the high monetary burden of the treatment of patients with bladder cancer. 14 The present study aimed to evaluate lawsuits against SUS to obtain better treatment for patients with bladder/ureteral cancer.…”

Role of Reactive C protein in Mediating the Effect of body mass index on bladder cancer Diseases

“…Bladder cancer ranks as the 10th most common cancer in terms of incidence and the 13th in terms of mortality among all cancers [2] . Furthermore, the cost of treating bladder cancer is signi cantly high [3] . The most common type of bladder cancer is non-muscle invasive bladder cancer (NMIBC), accounting for approximately three-quarters of all cases [4] .…”

The CABEM Initiative: Saving Patients With Muscle-invasive Bladder Cancer

“…The higher survival rate has also resulted in nurses having more experience in caring for patients with ostomies and oncologists developing greater expertise in treating MIBC, including NAC, adjuvant, and palliative care. We could also improve the recruitment of our research unit [6,7], and we are nowadays the top recruiter center of some of the international trials on bladder cancer in Brazil.…”