The cost-effectiveness of blue light cystoscopy in bladder cancer detection: United States projections based on clinical data showing 4.5 years of follow up after a single hexaminolevulinate hydrochloride instillation

Several studies, including the recently published phase III study by Stenzl and colleagues have demonstrated that hexaminolevulinate hydrochloride, when used with blue light fluorescence cystoscopy, improves detection of non-muscle invasive bladder tumors compared to white light cystoscopy and trans...

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Bibliographic Details
Published inCanadian journal of urology Vol. 20; no. 2; p. 6682
Main Authors Garfield, Susan S, Gavaghan, Meghan B, Armstrong, Shannon O, Jones, J Stephen
Format Journal Article
LanguageEnglish
Published Canada 01.04.2013
Subjects
Aged
Aminolevulinic Acid - analogs & derivatives
Cost-Benefit Analysis
Cystoscopy - economics
Cystoscopy - methods
Female
Follow-Up Studies
Humans
Male
Retrospective Studies
Software
United States - epidemiology
Urinary Bladder Neoplasms - diagnosis
Urinary Bladder Neoplasms - epidemiology
Urinary Bladder Neoplasms - surgery
United States
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Summary:Several studies, including the recently published phase III study by Stenzl and colleagues have demonstrated that hexaminolevulinate hydrochloride, when used with blue light fluorescence cystoscopy, improves detection of non-muscle invasive bladder tumors compared to white light cystoscopy and transurethral resection of bladder tumors (TURB) alone. The objective of this study was to conduct a detailed assessment of the cost-effectiveness of using hexaminolevulinate hydrochloride with blue light cystoscopy as an adjunct to white light versus white light cystoscopy alone at time of initial TURB in the United States. A probabilistic decision tree model, using TreeAge Pro 2011 software, was developed using base case scenario cost and utility estimates. Incorporation of hexaminolevulinate hydrochloride into diagnostic cystoscopy results in lower costs over 5 years ($25,921) as compared to those patients who initially receive white light cystoscopy ($30,581). Those patients who initially receive hexaminolevulinate hydrochloride blue light TURB also experience a lower overall cancer burden. Hexaminolevulinate hydrochloride may be cost effective when used at first TURB for patients with suspected new or recurrent non-muscle invasive bladder cancer.
ISSN:1195-9479