OBJECTIVES Bladder cancer is the 10^th most common cancer worldwide, and Lebanon has the highest incidence of bladder cancer in both men and women in the world estimated at 25 per 100,000. The aim of this study was to determine the inpatient (pharma and non-pharma) and outpatient costs of treating bladder cancer in Lebanon from the perspective of the private payer and National Social Security Fund (NSSF).

METHODS : A retrospective analysis of GlobeMed payer dataset, a third-party administrative patient data claims, was performed for the years 2008 to 2017. The outcomes of the study include annual population cost, cost per patient, cost by cost category, and cost by payer. The number of patients and their related costs were captured on a yearly basis and an average for each year was calculated. Standard deviation was calculated for each category over the studied period.

RESULTS The number of patients in this data cut were 940 (male=76.7%, female=23.7%) with an average age of 68, cross-validated with demographics from patients in the Ministry of Public Health (MOPH) national bladder cancer registry. From the private payer’s perspective, the bladder cancer-associated annual average cost per patient was $3,538. There was a 32% increase in the total average cost per-patient (2008=$3,114 /2017=$4,135) driven by increases in inpatient non-pharma costs. The limitations of the study were that the dataset does not include all types of payers in Lebanon, stage of the disease is not available, and analysis does not account for inflation over the studied period.

CONCLUSIONS Bladder cancer treatment costs in Lebanon have generally increased steadily over the last ten years. The major cost driver is the inpatient non-pharma costs. In the near future, increases in utilizations of immunotherapy treatments may result in a large increase in the average inpatient pharma cost.