当前位置: X-MOL 学术Bladder Cancer › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Alternating Cystoscopy with Bladder EpiCheck  ® in the Surveillance of Low-Grade Intermediate-Risk NMIBC: A Cost Comparison Model
Bladder Cancer ( IF 1.1 ) Pub Date : 2021-06-04 , DOI: 10.3233/blc-211528
Yair Lotan 1 , Georgios Gakis 2 , Matteo Manfredi 3 , Juan Morote 4 , Hugh Mostafid 5 , Francesco Porpiglia 3 , Cedric Poyet 6 , Morgan Roupret 7 , Claude Schulman 8 , Shahrokh F. Shariat 9, 10, 11 , Johannes Alfred Witjes 12
Affiliation  

Abstract

BACKGROUND:

Bladder cancer surveillance is invasive, intensive and costly. Patients with low grade intermediate risk non-muscle invasive bladder cancer (NMIBC) are at high risk of recurrence.

OBJECTIVE:

The objective of this model is to compare the cost of a strategy to alternate surveillance with cystoscopy and a urine marker, Bladder EpiCheck, to standard surveillance.

METHODS:

A decision tree model was built using TreeAge Pro Healthcare to compare standard surveillance (Standard) with a modified surveillance incorporating Bladder EpiCheck. The model was based on 2 years of surveillance. Outcomes were obtained from literature. Costs were obtained from US and 9 European countries. Sensitivity analyses were performed.

RESULTS:

The efficacy of the model was equivalent in terms of recurrence for each arm with median recurrence rate of 22%. When setting marker price at 200 local currency, the marker arm was less expensive in the USA, Netherlands, Switzerland, Belgium, Italy, Austria and UK by 154€ to 329€ per patient, for a 2-year period. Cost was higher in France, Spain, and Germany by 33–103€. Cost parity was achieved with marker price between 148€ and $421. Marker cost and specificity have the greatest impact on the overall model cost.

CONCLUSIONS:

A strategy alternating the urine marker Bladder EpiCheck with cystoscopy in the surveillance of patients with low grade intermediate risk bladder cancer is cost equivalent in the US and European countries when the marker is priced 148€ –$421, as a result of the marker’s high specificity (86%). Prospective studies will be necessary to validate these findings.



中文翻译:

交替膀胱镜检查与膀胱 EpiCheck ® 用于监测低级中危 NMIBC:成本比较模型

摘要

背景:

膀胱癌监测是侵入性的、密集的和昂贵的。低级别中危非肌层浸润性膀胱癌 (NMIBC) 患者的复发风险很高。

客观的:

该模型的目的是比较交替使用膀胱镜检查和尿液标记物膀胱 EpiCheck 进行监测的策略与标准监测的成本。

方法:

使用 TreeAge Pro Healthcare 构建了一个决策树模型,以比较标准监测(标准)与包含膀胱 EpiCheck 的改进监测。该模型基于 2 年的监测。结果来自文献。成本来自美国和 9 个欧洲国家。进行了敏感性分析。

结果:

该模型的疗效在每组的复发率方面是相同的,中位复发率为 22%。当将标记价格设置为 200 当地货币时,标记臂在美国、荷兰、瑞士、比利时、意大利、奥地利和英国的 2 年期间比每位患者便宜 154 至 329 欧元。法国、西班牙和德国的成本高出 33–103 欧元。标价在 148 欧元到 421 美元之间,实现了成本平价。标记成本和特异性对整体模型成本的影响最大。

结论:

在美国和欧洲国家,当标记物的价格为 148 欧元 – 421 美元时,由于标记物的高特异性,将尿液标记物膀胱 EpiCheck 与膀胱镜检查交替使用的策略在美国和欧洲国家的成本相当。 86%)。需要前瞻性研究来验证这些发现。

更新日期:2021-06-04
down
wechat
bug