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Cost-Utility of Hexaminolevulinate Blue Light Cystoscopy (Hal) Assisted Transurethral Resection of The Bladder Tumour (Turb) Compared to Turb With White Light Cystoscopy (Wlc) Alone In Patients With Non-Muscle Invasive Bladder Cancer (Nimbc) In Poland

2015; Elsevier BV; Volume: 18; Issue: 7 Linguagem: Inglês

10.1016/j.jval.2015.09.694

1524-4733

Zbigniew Jabłonowski, Tomasz Konecki, Maciej Ziobro, M. Haldas, Zbigniew Wolski, Florence Marteau, Marek Sosnowski,

Bladder and Urothelial Cancer Treatments

To evaluate cost-utility of HAL assisted TURB in comparison to TURB with WLC alone in patients with previously diagnosed NIMBC in Poland. Analysis was performed in 2014, from a public payer’s perspective with a lifetime horizon. “HAL cost-effectiveness model in non-muscle invasive bladder cancer (NIMBC)” by Pharmerit Ltd. was adapted to Polish settings. The model consists of two parts: a short-term decision tree to assess outcomes of TURB and a Markov cohort model developed in order to examine long-term outcomes. Clinical efficacy of HAL was based on a systematic review of randomized clinical trials. Data concerning course of disease and standard of care in Poland were based on available observational studies, expert opinion and guidelines. Difference in utilization of resources between HAL assisted TURB and TURB with WLC alone was estimated on the basis of expert survey. Unit costs of drugs and medical procedures were based on Ministry of Health (MoH) and National Health Fund tariffs. Costs and effects were discounted at rates of 5% and 3.5%, respectively. The cost-effectiveness threshold was set to 119,577 PLN according to MoH requirements. Probabilistic sensitivity analyses (PSA) were conducted to assess the probability that HAL is cost-effective in Polish settings. The difference in health outcomes between HAL assisted TURB and TURB with WLC alone was 0.034 QALY in favor of HAL. HAL assisted TURB was approximately 172 PLN more expensive than TURB with WLC alone. Incremental cost per QALY equaled 4,997 PLN. PSA indicated that HAL was cost-effective with probability of 95.9% and dominant with probability of 44.6%. Use of HAL to assist TURB is cost-effective in Poland when compared with TURB with WLC alone.