The Health Economics of Bladder Cancer: An Updated Review of the Published Literature

Abstract

The purpose of this paper is to provide a current view of the economic burden of bladder cancer, with a focus on the cost effectiveness of available interventions. This review updates a previous systematic review and includes 72 new papers published between 2000 and 2013. Bladder cancer continues to be one of the most common and expensive malignancies. The annual cost of bladder cancer in the USA during 2010 was $US4 billion and is expected to rise to $US5 billion by 2020. Ten years ago, urinary markers held the potential to lower treatment costs of bladder cancer. However, subsequent real-world experiments have demonstrated that further work is necessary to identify situations in which these technologies can be applied in a cost-effective manner. Adjunct cytology remains a part of diagnostic standard of care, but recent research suggests that it is not cost effective due to its low diagnostic yield. Analysis of intravesical chemotherapy after transurethral resection of bladder tumor (TURBT), neo-adjuvant therapy for cystectomy, and robot-assisted laparoscopic cystectomy suggests that these technologies are cost effective and should be implemented more widely for appropriate patients. The existing literature on the cost effectiveness of bladder cancer treatments has improved substantially since 2000. The body of work now includes many new models, registry analyses, and real-world studies. However, there is still a need for new implementation guidelines, new risk modeling tools, and a better understanding of the empirical burden of bladder cancer.

Modifiable risk factors for the prevention of bladder cancer: a systematic review of meta-analyses

“…Despite the reduction in exposure to some risk factors, significant exposure, and thus disease, remains. This means that the burden on the health care system will remain substantial especially when considering that at least 50 % of bladder cancers recur [12] and long-term monitoring of patients is required, resulting in the highest per patient lifetime costs amongst all cancers [13]. For example, in the US, the annual cost of care of bladder cancer was estimated to be $US4 billion.…”

Predictors of costs associated with radical cystectomy for bladder cancer: A population‐based retrospective cohort study in the province of Quebec, Canada

“…This disease has the highest lifetime treatment costs per patient of all cancers . These costs vary greatly depending on the country and the health‐care system .…”

Deep Sequencing of Urinary RNAs for Bladder Cancer Molecular Diagnostics

“…While most bladder cancers are non-muscle invasive at initial diagnosis, the high recurrence rate and potential to progress to invasive disease necessitates frequent surveillance cystoscopy, contributing to bladder cancer as one of the most expensive cancers to treat (18). To date, a non-invasive test with sufficient accuracy to reduce the frequency of cystoscopy in low-risk patients, while providing timely treatment in high-risk patients, has remained elusive.…”