OBJECTIVES

The use of photodynamic diagnosis using BL TURB may reduce the recurrence risk in non-muscle invasive BCa compared to standard WL diagnosis due to a more sensitive tumor detection. The impact of the initial use of WL- vs. BL-TURB on follow-up costs and therapies was evaluated in this real-world data analysis.

METHODS

Anonymous healthcare claims data from >60 health insurance companies (2011-2016, n = 4,580,432) were analysed (5 quarters before enrolment, 1 index quarter (InQ) with initial BCa diagnosis & TURB between Q2/2012 and Q1/2016, 3 quarters of Follow-Up (FU)).

RESULTS

In a first data analysis, cystectomy was identified as an important cost driver masking potential differences between treatment groups. Therefore, patients not undergoing cystectomy (InQ+FU) were selected, resulting in a total study population of n=4,541 patients (79% WL: n=3,582; 21% BL: n=959). In the InQ, the mean total costs were similar (WL: €4,534; BL: €4,543), the median total costs being slightly increased in the BL group (€3,704 vs. €3,320). During FU, the mean total costs were significantly higher in the WL group (€7,073 vs. BL €6,431, p=0.045). Considering a quarterly breakdown, the in-between mean cost variations became more obvious (WL: €4,534 (InQ), €3,081 (Q1), €2,048 (Q2), €1,945 (Q3); BL: €4,543 (InQ), €2,716 (Q1), €1,853 (Q2) €1,863 (Q3)). Towards end of FU, the quarterly and total mean costs (WL: €11,607; BL: €10,974) were approaching, implying a waning “BL-TURB effect”. Subsequent treatments following initial TURB included mostly WL-TURB and cystoscopies in both groups. Evaluations on FU therapies indicate a need of improvement in Guidelines adherence.

CONCLUSIONS

This health service research of mean total costs after initial WL- vs. BL-TURB shows intermittently a significant cost reduction in the BL group, with comparable cost level after one year.