Open Access

ARTICLE

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

Susan S. Garfield¹, Meghan B. Gavaghan¹, Shannon O. Armstrong¹, J. Stephen Jones²

1 GfK Bridgehead, Wayland, Massachusetts, USA
2 Department of Urology, Cleveland Clinic, Cleveland, Ohio, USA
Address correspondence to Dr. Susan S. Garfield, 21 Cochituate Road, Wayland, MA 01778 USA

Canadian Journal of Urology 2013, 20(2), 6682-6689.

Abstract

Introduction: 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.
Materials and methods: 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 the 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.
Results: 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.
Conclusions: Hexaminolevulinate hydrochloride may be cost-effective when used at first TURB for patients with suspected new or recurrent non-muscle invasive bladder cancer.

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