Impact on Japanese healthcare economics of photodynamic diagnosis‐assisted transurethral resection of bladder tumor for non‐muscle invasive bladder cancer: A multicenter retrospective cohort study

Abstract

ObjectivesBladder cancer, especially non‐muscle invasive bladder cancer (NMIBC), is one of the most costly cancers owing to its long‐term management. Photodynamic diagnosis‐assisted transurethral resection of bladder tumor (PDD‐TURBT) reduces the risk of intravesical recurrence. However, its impact on healthcare economics in Japan remains unclear. We evaluated the comprehensive medical costs of Japanese healthcare economics regarding PDD‐TURBT.MethodsThis large‐scale, multicenter, retrospective study included a dataset of 1531 patients who were diagnosed with primary NMIBC who underwent initial TURBT between April 2006 and June 2021. A one‐to‐one propensity‐score matching analysis was used for an unbiased comparison based on postTURBT follow‐up periods. The total medical costs, including hospitalization, surgical procedures for TURBT and salvage radical cystectomy, adjuvant intravesical therapies, and follow‐up examinations, were compared between white light (WL)‐TURBT and PDD‐TURBT groups.ResultsAfter propensity‐score matching, 468 patients each of WL‐ and PDD‐TURBT groups were matched. Total costs were 510 337 128 and 514 659 328 ¥ in WL‐ and PDD‐TURBT groups, respectively. The costs of adjuvant intravesical therapies, follow‐up examinations, and salvage radical cystectomy in PDD‐TURBT group were equivalent to or lower than those in WL‐TURBT group. Furthermore, total costs of high‐ and highest‐risk NMIBC in PDD‐TURBT group were either equivalent or lower compared to those in WL‐TURBT group.ConclusionsThe total costs associated with PDD‐TURBT were higher compared to WL‐TURBT, while there is the potential of PDD‐TURBT to reduce the burden on healthcare economics in limited cases.

Editorial Comment to Impact on Japanese healthcare economics of photodynamic diagnosis‐assisted transurethral resection of bladder tumor for non‐muscle invasive bladder cancer: A multicenter retrospective cohort study

“…1 These data raise the expectation that PDD-TURBT might contribute to the reduction of the comprehensive medical costs of NMIBC treatment.In this paper, Nishimura et al compared the total costs of PDD-TURBT and WL-TURBT, encompassing not only the immediate perioperative care but also encompassing the follow-up and subsequent treatment costs such as salvage radical cystectomy. 2 In their analyses, the total costs of PDD-TURBT were slightly higher than those of WL-TURBT. However, their results indicated that PDD-TURBT had the potential to reduce the burden on healthcare economics pertaining to high-risk and highest-risk NMIBC.…”

“…In this paper, Nishimura et al. compared the total costs of PDD‐TURBT and WL‐TURBT, encompassing not only the immediate perioperative care but also encompassing the follow‐up and subsequent treatment costs such as salvage radical cystectomy 2 . In their analyses, the total costs of PDD‐TURBT were slightly higher than those of WL‐TURBT.…”