Budget impact of incorporating one instillation of hexaminolevulinate hydrochloride blue- light cystoscopy in trans-urethral bladder tumour resection for non-muscle invasive bladder cancer patients in Sweden

To explore the cost impact on Swedish healthcare of incorporating one instillation of hexaminolevulinate hydrochloride (HAL) blue light cystoscopy into the transurethral resection of bladder tumours (TURBT) in patients with suspected new or recurrent non-muscle invasive bladder cancer (NMIBC).

A decision tree model was built based on European Association of Urology guidelines for the treatment and management of NMIBC. Input data was compiled from two recent studies comparing recurrence rates of bladder cancer in patients undergoing TURBT with the current standard of care (SOC) of white light cystoscopy, or with the SOC and HAL blue light cystoscopy. Using this published data with clinical cost data for surgical and outpatient procedures and pharmaceutical costs the model reported on clinical and economic differences associated with the two treatment options.

This model demonstrates the significant clinical benefits likely to be observed through the incorporation of HAL blue light cystoscopy for TURBT in terms of reductions in recurrences of bladder cancer. Analysis of economic outputs of the model found that the use of one instillation of HAL for TURBT in all Swedish NMIBC patients is likely to be cost neutral or cost saving over 5 years relative to the current SOC of white light cystoscopy.

The results of this analysis provide additional health economic rationale for the incorporation of a single instillation of HAL blue light cystoscopy for TURBT in the treatment of NMIBC patients in Sweden. This article is protected by copyright All rights reserved.

BJU international 2015 Aug 25 [Epub ahead of print]

James B Rose, Shannon Armstrong, Gregers G Hermann, Jacob Kjellberg, Per-Uno Malmström

GfK, Pera Business Park, Melton Mowbray, LE13 0PB, UK , GfK, 21 Cochituate Road, Wayland, MA 01778, USA , Department of Urology, University Hospital of Copenhagen, Frederiksberg hospital, Copenhagen , Danish Institute for Local and Regional Government Research (KORA), Copenhagen, Denmark , Department of Surgical Sciences, Uppsala University, Akademiska sjukhuset, Ing 70 1tr, 751 85, Uppsala, Sweden