The Impact of Bacillus Calmette-Guérin Shortage on Non-Muscle-Invasive Bladder Cancer Patients - Expert Commentary

A shortage of the Bacillus Calmette-Guérin (BCG) Connaught strain occurred between 2013-2016. A recent paper published by Ourfali et al. in European Urology Focus investigated the medical and financial sequelae of BCG shortage on intermediate-risk and high-risk NMIBC patients between 2013 and 2016.

The study included two groups. The control group included 191 patients who were treated between November 2011 and September 2013, whereas the study group included 211 who were treated during the BCG shortage between October 2013 and December 2016. The investigators identified significant negative and economic consequences from BCG shortage. The recurrence rate was higher in the study group (46.9%) compared to the control group (16.2%); relative risk: 0.7, 95% confidence interval [0.60; 0.82]; p < 0.001). During the period of interruption of BCG production, the excess cost was €783 per newly diagnosed NMIBC patient.

Because there are no approved alternatives to BCG for high-risk non-muscle-invasive bladder cancer patients, maintaining BCG production and preventing shortages are critical for optimal care of NMIBC patients.

Written by: Bishoy M. Faltas, MD, Director of Bladder Cancer Research, Englander Institute for Precision Medicine, Weill Cornell Medicine

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References:
1. Ourfali S, Ohannessian R, Fassi-Fehri H, Pages A, Badet L, Colombel M. Recurrence Rate and Cost Consequence of the Shortage of Bacillus Calmette-Guérin Connaught Strain for Bladder Cancer Patients. Eur Urol Focus. 2019 Apr 17. pii: S2405-4569(19)30109-9. doi: 10.1016/j.euf.2019.04.002.
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