Economic Burden and Healthcare Resource Utilization (HCRU) Associated with High-Risk Papillary Stage Ta & T1 (PAPTa1) Non-Muscle Invasive Bladder Cancer (NMIBC) Patients, 2008-2019
Author(s)
Stephen Williams, MD1, Arveen Kaur, PhD2, Jinghua He, PhD2, Wenxi Huang, MS2, Hiremagalur Balaji, MD2, Kruti Joshi, MS2, Lorie Ellis, PhD2, Mukul Singhal, PhD2;
1The University of Texas Medical Branch, Galveston, TX, USA, 2Johnson & Johnson, Horsham, PA, USA
1The University of Texas Medical Branch, Galveston, TX, USA, 2Johnson & Johnson, Horsham, PA, USA
Presentation Documents
OBJECTIVES: Approximately 75% of bladder cancer (BC) cases are non-muscle invasive (NMIBC), with a five-year recurrence risk of 31-78%. Patients with high-grade Papillary Ta & T1 (PAPTa1) NMIBC have a substantially worse prognosis. Intravesical Bacillus Calmette-Guérin (iBCG) and Intravesical Gemcitabine (iGEM) are the most commonly used treatments in these patients. However, there is a lack of evidence on economic burden. This study assessed the healthcare cost and healthcare resource utilization (HCRU) among high-risk PAPTa1 NMIBC patients receiving iBCG or iGEM.
METHODS: This retrospective cohort study used the SEER-Medicare database to identify patients aged ≥65 years diagnosed with high-grade PAPTa1 NMIBC during 2008-2019, receiving iBCG or iGEM as the first intravesical treatment. All included patients had continuous Medicare Fee-for-Service (FFS) enrollment for ≥12 months prior to the index date (1st treatment date). All-cause and BC-related HCRU and costs were summarized as per-person-per-year (PPPY) descriptively from the index date until the latest available Medicare data (12/31/2020), Medicare FFS disenrollment, or death.
RESULTS: A total of 10,731 patients with high-grade PaPTa1 NIMBC receiving iBCG or iGEM were included (mean age 77.3 years, male 80.7%, White 94.1%, mean NCI Comorbidity Index 0.73 (SD=0.66)). During a mean follow-up of 4.3 years, the mean PPPY rates for emergency room visit, hospital admission, physician office visit, and outpatient encounter were 1.0 (SD=1.5), 0.9 (SD=1.6), 13.3 (SD=8.6), 7.9 (SD=8.2), respectively. The average all-cause cost PPPY was $30,425 (SD=$42,802), and the average BC-related cost PPPY was $10,576 (SD=$23,110). Approximately 50% of the healthcare costs were inpatient costs (all-cause mean=$14,177 (SD=$32,632), BC-related mean=$4,659 (SD=$18,300)).
CONCLUSIONS: High-risk PAPTa1 NMIBC patients treated with iBCG or iGEM incur significant all-cause and BC-related HCRU and costs. New treatments that reduce healthcare utilization could provide significant benefits for both the health system and patients.
METHODS: This retrospective cohort study used the SEER-Medicare database to identify patients aged ≥65 years diagnosed with high-grade PAPTa1 NMIBC during 2008-2019, receiving iBCG or iGEM as the first intravesical treatment. All included patients had continuous Medicare Fee-for-Service (FFS) enrollment for ≥12 months prior to the index date (1st treatment date). All-cause and BC-related HCRU and costs were summarized as per-person-per-year (PPPY) descriptively from the index date until the latest available Medicare data (12/31/2020), Medicare FFS disenrollment, or death.
RESULTS: A total of 10,731 patients with high-grade PaPTa1 NIMBC receiving iBCG or iGEM were included (mean age 77.3 years, male 80.7%, White 94.1%, mean NCI Comorbidity Index 0.73 (SD=0.66)). During a mean follow-up of 4.3 years, the mean PPPY rates for emergency room visit, hospital admission, physician office visit, and outpatient encounter were 1.0 (SD=1.5), 0.9 (SD=1.6), 13.3 (SD=8.6), 7.9 (SD=8.2), respectively. The average all-cause cost PPPY was $30,425 (SD=$42,802), and the average BC-related cost PPPY was $10,576 (SD=$23,110). Approximately 50% of the healthcare costs were inpatient costs (all-cause mean=$14,177 (SD=$32,632), BC-related mean=$4,659 (SD=$18,300)).
CONCLUSIONS: High-risk PAPTa1 NMIBC patients treated with iBCG or iGEM incur significant all-cause and BC-related HCRU and costs. New treatments that reduce healthcare utilization could provide significant benefits for both the health system and patients.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE288
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology