Institutional Trends and Healthcare Resource Utilization in Real-World NMIBC and MIBC Treatment in Germany
Author(s)
Zuzana Dostalova, M.Sc., Kai Strobel, BSc, MSc, Ewelina Kubietz, M.Sc., Stefanie Spirin, M.Sc., Maria Stefanie Friese, BSc, Franziska Haug, M.Sc., Markus Rückert, Ph.D..
TriNetX Oncology GmbH, Freiburg, Germany.
TriNetX Oncology GmbH, Freiburg, Germany.
OBJECTIVES: Treatment decisions in bladder cancer vary by institutional setting. This study examines the impact of hospital type on treatment choices and resource utilization in NMIBC and MIBC in Germany.
METHODS: We conducted an epidemiologic survey of relevant treating centers to assess the numbers of NMIBC or MIBC patients whose initial diagnosis was before 2022, and who were prevalent/incident in 2023 HY2 from university hospitals (UHs), non-university hospitals (NUHs), and office-based practices (OBP) in Germany. Key variables included patient characteristics, TURB and cystectomy rates, systemic therapy use, and referral patterns. The survey results were used to generate 1-year estimates of treated prevalence and incidence for Germany in 2023.
RESULTS: 291 highly care-relevant German centers for NMIBC and MIBC were determined (144; 49% OBP, 131; 45% NUH, 16 pts; 5% UH). Based on the survey, 21,935 NMIBC and 7,290 MIBC patients were estimated in the half-year prevalence (HY2/2023). In the collected patient-level data (250 MIBC, 312 NMIBC), hospital-based urologists were primarily performing (N)MIBC screening and diagnosis (328 of 413 screenings; 79%, vs 85 pts; 21% office-based urologists). Oncologists are mainly involved in systemic MIBC treatment (37 of 85 neoadjuvant, 23 of 79 adjuvant therapies). TURB in 1L MIBC was primarily performed in NUHs (163 of 211; 77% of 1L performed TURBs). Cystectomy was more frequent in UHs post-recurrence in 2L (41 of 54 cystectomies; 76% vs. 13; 24% in NUHs). Tumor board referrals originated primarily from hospital-based urologists. Among incident 2L MIBC patients (98), 43 (44%) started palliative care. 95 (68%) 2L MIBC patients were platinum-eligible, yet systemic therapy was underutilized (39; 28%).
CONCLUSIONS: Significant institutional differences exist in bladder cancer treatment, with UHs more likely to perform cystectomies and NUHs conducting most TURBs. High reliance on hospital-based urologists and limited systemic therapy use in MIBC suggest gaps in multidisciplinary management and resource allocation.
METHODS: We conducted an epidemiologic survey of relevant treating centers to assess the numbers of NMIBC or MIBC patients whose initial diagnosis was before 2022, and who were prevalent/incident in 2023 HY2 from university hospitals (UHs), non-university hospitals (NUHs), and office-based practices (OBP) in Germany. Key variables included patient characteristics, TURB and cystectomy rates, systemic therapy use, and referral patterns. The survey results were used to generate 1-year estimates of treated prevalence and incidence for Germany in 2023.
RESULTS: 291 highly care-relevant German centers for NMIBC and MIBC were determined (144; 49% OBP, 131; 45% NUH, 16 pts; 5% UH). Based on the survey, 21,935 NMIBC and 7,290 MIBC patients were estimated in the half-year prevalence (HY2/2023). In the collected patient-level data (250 MIBC, 312 NMIBC), hospital-based urologists were primarily performing (N)MIBC screening and diagnosis (328 of 413 screenings; 79%, vs 85 pts; 21% office-based urologists). Oncologists are mainly involved in systemic MIBC treatment (37 of 85 neoadjuvant, 23 of 79 adjuvant therapies). TURB in 1L MIBC was primarily performed in NUHs (163 of 211; 77% of 1L performed TURBs). Cystectomy was more frequent in UHs post-recurrence in 2L (41 of 54 cystectomies; 76% vs. 13; 24% in NUHs). Tumor board referrals originated primarily from hospital-based urologists. Among incident 2L MIBC patients (98), 43 (44%) started palliative care. 95 (68%) 2L MIBC patients were platinum-eligible, yet systemic therapy was underutilized (39; 28%).
CONCLUSIONS: Significant institutional differences exist in bladder cancer treatment, with UHs more likely to perform cystectomies and NUHs conducting most TURBs. High reliance on hospital-based urologists and limited systemic therapy use in MIBC suggest gaps in multidisciplinary management and resource allocation.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD107
Topic
Real World Data & Information Systems
Disease
Oncology, Urinary/Kidney Disorders