The impact of avoiding recurrence: New BRAVO Study abstract at SUO 2025 demonstrates Cost Neutrality in Blue Light versus White Light Cystoscopy comparison
"Bladder cancer is associated with high treatment costs. A significant portion of cost is related to the high rates of cancer recurrence. In our study, utilization of BLC in the management of NMIBC was associated with modestly higher healthcare costs compared to white light. However, the majority of cost was related to increased use of guideline recommended intravesical therapy in the BLC cohort due to early detection of tumor. Early detection facilitated by BLC, appropriate intravesical therapy, and reduced recurrence significantly narrowed the cost differential that approached net cost neutrality compared to WL while providing superior clinical outcomes. These findings provide real-world cost data to aid in the decision-making process for utilizing BLC particularly in the care of high-risk NMIBC patients," said Dr.
The BRAVO study (Bladder Cancer Recurrence Analysis in Veterans and Outcomes) is a propensity score matched, retrospective analysis evaluating outcomes following BLC compared to WLC alone in 622 patients from the
Results:
- BLC vs. WLC patients were more likely to receive intravesical BCG (61 vs 43%; p<0.01) and intravesical chemotherapy (49% and 28%, p<0.01), respectively.
- BLC use was associated with decreased risk or recurrence (HR 0.62, p<0.01)
- Initial total costs over 5 years were higher in the BLC group (
$108,411 vs$66,734 ; p<0.01), with outpatient costs being the main driver ($90,788 vs$55,529 ; p<0.01). - A cost-offset analysis showed that the 5-year costs of BLC exposure were only
$721 more per person versus WLC due to shorter hospital stays, fewer emergency visits, and fewer recurrence events.
Conclusions: In a real-world equal-access setting, initial 5-year total costs for BLC were higher, mostly driven by outpatient costs likely related to increased utilization of intravesical therapies and closer surveillance in BLC patients. However, given lower recurrence rates with BLC and accounting for the costs of treating recurrence, the adjusted cost difference approaches net neutral.
"The BRAVO results, showing that BLC reduces recurrence vs WLC in a cost efficient way, is consistent with other real world studies such as e.g. the recently published business impact model in 4 European countries BLC helps improving quality of NMIBC care, benefiting both patients and healthcare providers while managing costs," said Anders Neijber, Chief Medical Officer of
Read the study abstract here: https://suo-abstracts.secure-platform.com/a/gallery/rounds/24/details/4541
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About Bladder Cancer
Bladder cancer ranks as the 8th most common cancer worldwide – the 5th most common in men – with 1 949 000 prevalent cases (5-year prevalence rate)1a, 614 000 new cases and more than 220 000 deaths in 2022.1b
Approx. 75% of all bladder cancer cases occur in men.1 It has a high recurrence rate with up to 61% in year one and up to 78% over five years.2 Bladder cancer has the highest lifetime treatment costs per patient of all cancers.3
Bladder cancer is a costly, potentially progressive disease for which patients have to undergo multiple cystoscopies due to the high risk of recurrence. There is an urgent need to improve both the diagnosis and the management of bladder cancer for the benefit of patients and healthcare systems alike.
Bladder cancer is classified into two types, non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC), depending on the depth of invasion in the bladder wall. NMIBC remains in the inner layer of cells lining the bladder. These cancers are the most common (75%) of all BC cases and include the subtypes Ta, carcinoma in situ (CIS) and T1 lesions. In MIBC the cancer has grown into deeper layers of the bladder wall. These cancers, including subtypes T2, T3 and T4, are more likely to spread and are harder to treat.4
1 Globocan. a) 5-year prevalence / b) incidence/mortality by population. Available at: https://gco.iarc.fr/today, accessed [February 2024].
2 Babjuk M, et al. Eur Urol. 2019; 76(5): 639-657
3 Sievert KD et al. World J Urol 2009;27:295–300
4 Bladder Cancer.
About Hexvix®/Cysview® (hexaminolevulinate HCl)
Hexvix/Cysview is a drug that preferentially accumulates in cancer cells in the bladder, making them glow bright pink during Blue Light Cystoscopy (BLC®). BLC with Hexvix/Cysview, compared to standard white light cystoscopy alone, improves the detection of tumors and leads to more complete resection, fewer residual tumors, and better management decisions.
Cysview is the tradename in the
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