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The Health Economics of Bladder Cancer: An Updated Review of the Published Literature

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Abstract

The purpose of this paper is to provide a current view of the economic burden of bladder cancer, with a focus on the cost effectiveness of available interventions. This review updates a previous systematic review and includes 72 new papers published between 2000 and 2013. Bladder cancer continues to be one of the most common and expensive malignancies. The annual cost of bladder cancer in the USA during 2010 was $US4 billion and is expected to rise to $US5 billion by 2020. Ten years ago, urinary markers held the potential to lower treatment costs of bladder cancer. However, subsequent real-world experiments have demonstrated that further work is necessary to identify situations in which these technologies can be applied in a cost-effective manner. Adjunct cytology remains a part of diagnostic standard of care, but recent research suggests that it is not cost effective due to its low diagnostic yield. Analysis of intravesical chemotherapy after transurethral resection of bladder tumor (TURBT), neo-adjuvant therapy for cystectomy, and robot-assisted laparoscopic cystectomy suggests that these technologies are cost effective and should be implemented more widely for appropriate patients. The existing literature on the cost effectiveness of bladder cancer treatments has improved substantially since 2000. The body of work now includes many new models, registry analyses, and real-world studies. However, there is still a need for new implementation guidelines, new risk modeling tools, and a better understanding of the empirical burden of bladder cancer.

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Acknowledgments

The authors wish to thank Andrea Kress for writing and editing assistance in the preparation of this manuscript.

Tuan Dinh and Joseph Lee have previously worked on a consulting project for Pacific Edge Limited. Pacific Edge markets Cxbladder, a non-invasive, urine-based detection test to determine the likelihood of bladder cancer in patients presenting with hematuria. Christina Yeung does not have any relevant conflicts of interest. T Dinh, J Lee, and C Yeung all contributed to the compilation of articles, and discussion and review of this article. C Yeung and J Lee wrote sections 1, 2, and 6 and sections 3, 4 and 7 of the manuscript, respectively. T Dinh drafted section 5 with assistance from Andrea Kress and is the guarantor of the work.

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  1. Evidera, San Francisco, CA, USA

    Christina Yeung, Tuan Dinh & Joseph Lee

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  1. Christina Yeung
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  2. Tuan Dinh
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Correspondence to Christina Yeung.

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Yeung, C., Dinh, T. & Lee, J. The Health Economics of Bladder Cancer: An Updated Review of the Published Literature. PharmacoEconomics 32, 1093–1104 (2014). https://doi.org/10.1007/s40273-014-0194-2

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