Increasing costs from bladder cancer in the Brazilian Health System: the role of establishing public health policies

Korkes, Fernando; Maluf, Fernando C.

doi:10.1590/s1677-5538.ibju.2020.0658

Cited by 6 publications

(4 citation statements)

References 8 publications

(14 reference statements)

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“…Therefore, these initial costs might become much higher during a longer follow-up. And for stage IV disease, they might become even higher in the years to come with the possible incorporation of new agents as immunotherapeutics [13,14].…”

Section: Discussionmentioning

confidence: 99%

Stage-Related Cost of Treatment of Bladder Cancer in Brazil

Korkes

Timóteo

Soledade

et al. 2022

PharmacoEconomics Open

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Purpose Bladder cancer is the ninth most frequent cancer worldwide with the twelfth highest incidence. However, its treatment has financial impacts that directly affect health burden. There is a scarcity of data about the costs related to healthcare in Brazil, especially in the public setting. As previously demonstrated, despite not being one of the most frequent cancers, bladder cancer appears to be one of the most expensive. The present study aimed to assess the costs related to the treatment of bladder cancer in the public setting in Brazil. Patients and Methods Retrospective data of patients treated for urothelial bladder carcinoma from 2019 to 2020 were retrieved at a single center. All charts were reviewed, with the assessment of clinical data, exams, surgical data, and postprocedure outcomes. The hospital finance department calculated the costs for outpatient evaluation, inpatient procedures, complementary exams, materials, drugs, and professionals' fees throughout all operations. Results A total of 107 patients with bladder cancer were analyzed, representing a total expenditure of BRL 5,671,042.70 and a mean cost of BRL 53,000.04 per patient (US$1.00 = BRL 5.60). Median costs were progressively higher for patients with stages I, II, III, and IV. Patients who underwent radical cystectomy (n = 14) had a median treatment cost of BRL 136,606.25 ± 96,059.08, during a mean follow-up of 9.2 months. Hospitalization costs represented 25% (range 20-43% according to the stage) of all expenditure. Medications and medical supplies represented 18% (16-23% according to the stage) of expenditure. Medical fees represented 31% of costs for stage I disease, but only 4% in stage II, III, and IV. Costs associated with emergency room visits were only observed in stage III and IV disease, representing 1% of all expenditure. Conclusions The management of bladder cancer resulted in a significant economic burden on our public health system. The costs associated with stage I bladder cancer were 4-12 times higher than those related to the treatment of other common malignancies at initial stages. Treatment was also expensive during the first months with more advanced stages.

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Section: Discussionmentioning

confidence: 99%

Stage-Related Cost of Treatment of Bladder Cancer in Brazil

Korkes

Timóteo

Soledade

et al. 2022

PharmacoEconomics Open

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“…(9) In such a context, knowledge of the molecular profile of MIBC in Brazil is fundamental to define better public health strategies, for it can have major impacts. (10)…”

Section: ❚ Introductionmentioning

confidence: 99%

Fibroblast growth factor receptor 3 gene (FGFR3) mutations in high-grade muscle-invasive urothelial bladder cancer in a Brazilian population: evaluation and prevalence

Monteiro

Korkes

Krutman-Zveibil

et al. 2022

Einstein (São Paulo)

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Objective: To understand the feasibility of FGFR3 tests in the Brazilian public health context, and to sample the mutational burden of this receptor in high-grade muscle invasive bladder cancer. Methods: A total of 31 patients with high-grade muscle-invasive bladder cancer were included in the present study. Either transurethral resection of bladder tumor or radical cystectomy specimens were analyzed. Formalin-fixed paraffin-embedded tissue blocks were sectioned, hematoxylin and eosin stained, and histologic sections were reviewed. Total RNA was extracted using the RNeasy DSP formalin-fixed paraffin-embedded kit. Qualitative results were displayed in Rotor-Gene AssayManager software. Results: Six patients were excluded. From the samples analyzed, four (16.7%) were considered inadequate and could not have their RNA extracted. Two patients presented FGFR3 mutations, accounting for 9.5% of material available for adequate analysis. The two mutations detected included a Y373C mutation in a male patient and a S249C mutation in a female patient. Conclusion: FGFR3 mutations could be analyzed in 84% of our cohort and occurred in 9.5% of patients with high-grade muscle invasive bladder cancer in this Brazilian population. FGFR3 gene mutations are targets for therapeutic drugs in muscle-invasive bladder cancer. For this reason, know the frequency of these mutations can have a significant impact on public health policies and costs provisioning.

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“…The relevance of BC, however, cannot be estimated only by those numbers. Not only is the mortality rate a significant concern in BC, but also the high rate of recurrence has a great impact on quality of life of a significant portion of patients with BC (8) and the high lifetime treatment-associated costs (10,11).…”

Section: Introductionmentioning

confidence: 99%

VI-RADS score system - A primer for urologists

et al. 2022

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Bladder cancer (BCa) is one of the most common cancers worldwide and is also considered to be one of the most relapsing and aggressive neoplasms. About 30% of patients will present with muscle invasive disease, which is associated with a higher risk for metastatic disease. The aim of this article is to review the state of art imaging in Radiology, while providing a complete guide to urologists, with case examples, for the rationale of the development of the Vesical Imaging Reporting and Data System (VI-RADS), a scoring system emphasizing a standardized approach to multiparametric Magnetic Resonance Imaging (mpMRI) acquisition, interpretation, and reporting for BCa. Also, we examine relevant external validation studies and the consolidated literature of mpMRI for bladder cancer. In addition, this article discusses some of the potential clinical implications of this scoring system for disease management and follow-up.

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Increasing costs from bladder cancer in the Brazilian Health System: the role of establishing public health policies

Cited by 6 publications

References 8 publications

Stage-Related Cost of Treatment of Bladder Cancer in Brazil

Stage-Related Cost of Treatment of Bladder Cancer in Brazil

Fibroblast growth factor receptor 3 gene (FGFR3) mutations in high-grade muscle-invasive urothelial bladder cancer in a Brazilian population: evaluation and prevalence

VI-RADS score system - A primer for urologists

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