The Financial Burden of Localized and Metastatic Bladder Cancer
Language English Country Switzerland Media print-electronic
Document type Journal Article, Systematic Review
PubMed
39730299
DOI
10.1016/j.eururo.2024.12.002
PII: S0302-2838(24)02744-1
Knihovny.cz E-resources
- Keywords
- Cost effectiveness, Financial burden, Financial toxicity, Metastatic bladder cancer, Muscle-invasive bladder cancer, Non–muscle-invasive bladder cancer, cost,
- MeSH
- Cost-Benefit Analysis MeSH
- Cystectomy economics adverse effects MeSH
- Humans MeSH
- Neoplasm Metastasis MeSH
- Urinary Bladder Neoplasms * economics therapy pathology MeSH
- Health Care Costs * MeSH
- Cost of Illness * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Systematic Review MeSH
BACKGROUND AND OBJECTIVE: Bladder cancer (BCa) imposes a substantial economic burden on health care systems and patients. Understanding these financial implications is crucial for effective resource allocation and optimization of treatment cost effectiveness. Here, we aim to systematically review and analyze the financial burden of BCa from the health care and patient perspectives. METHODS: A Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-compliant systematic review was conducted, searching PubMed/Medline, Embase, and public sources for studies evaluating the financial impact of BCa, encompassing costs, cost effectiveness, and financial toxicity (FT). KEY FINDINGS AND LIMITATIONS: Non-muscle-invasive BCa (NMIBC) incurs significant costs for surveillance and treatment, with costs exceeding $200 000 after 5 yr for high-risk NMIBC patients progressing after bacillus Calmette-Guerin (BCG) treatment (including inpatient, outpatient, and physician service expenses). Muscle-invasive BCa generates substantial costs from radical cystectomy (RC) and neoadjuvant chemotherapy, averaging $30 000-40 000 from surgical costs of RC, with additional expenses in case of complications. Trimodal therapy has higher costs (1-yr management cost >$200 000) than RC because of higher outpatient, radiology, and medication costs. Metastatic BCa incurs the highest financial burden, with systemic therapy costs ranging from $40 000 to over $100 000 per five-cycle course, increasing further with combination therapies (ie, enfortumab vedotin and pembrolizumab), treatment-related toxicity, and supportive care. FT is particularly prevalent among younger, less educated, and minority populations. CONCLUSIONS AND CLINICAL IMPLICATIONS: BCa treatment, particularly in advanced stages, imposes a substantial economic burden. Innovations in care, while improving oncologic outcomes, necessitate detailed cost-effectiveness assessments. Addressing these economic challenges is essential for optimizing BCa management, targeting patients at a higher risk of FT, and improving patient quality of life.
Dana Farber Cancer Institute Boston MA USA
Department of Experimental Oncology Unit of Urology URI IRCCS Ospedale San Raffaele Milan Italy
Department of Genitourinary Oncology Moffitt Cancer Center Tampa FL USA
Department of Urologic Sciences University of British Columbia Vancouver BC Canada
Department of Urology University of Texas MD Anderson Cancer Center Houston TX USA
Department of Urology University of Washington School of Medicine Seattle WA USA
References provided by Crossref.org
