Todenhöfer Tilman, Maas Moritz, Ketz Miriam, Kossack Nils, Colling Christiane, Qvick Bryan, Stenzl Arnulf
Department of Urology, University of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
Studienpraxis Urologie, Steinengrabenstr. 17, 72622, Nürtingen, Germany.
World J Urol. 2021 Aug;39(8):2953-2960. doi: 10.1007/s00345-020-03587-0. Epub 2021 Feb 10.
Photodynamic diagnosis using hexaminolevulinate (HAL)-guided BL-TURB may reduce the recurrence risk in non-muscle invasive BCa compared to standard WL-TURB due to more sensitive tumor detection. The impact of the initial use of WL- vs. BL-TURB on follow-up costs was evaluated in this real-world data analysis.
Anonymous claims data of German statutory health insurances (GKV) from 2011 to 2016 were analyzed in a primary and adjusted study population. Selection criteria included five quarters before enrolment, one index quarter (InQ) of initial TURB and BCa diagnosis, either within two years for the primary analysis or within four years for the adjusted analysis, and a follow-up period (FU) of either eleven or three quarters, respectively.
In the primary analysis (n = 2331), cystectomy was identified as an important cost driver masking potential differences between cohorts. Therefore, patients undergoing cystectomy (InQ + FU) were excluded from the adjusted study population of n = 4541 patients (WL: 79%; BL: 21%). Mean total costs of BL-TURB were initially comparable to WL-TURB (WL: EUR 4534 vs. BL: EUR 4543) and tended to be lower compared to WL-TURB in the first two quarters of FU. After one year (3rd FU quarter), costs equalized. Considering total FU, mean costs of BL-TURB were significantly lower compared to WL-TURB (WL: EUR 7073 vs BL: EUR 6431; p = 0.045).
This retrospective analysis of healthcare claims data highlights the comparability of costs between BL-TURB and WL-TURB.
与标准白光膀胱肿瘤电切术（WL-TURB）相比，使用六氨基乙酰丙酸（HAL）引导的蓝光膀胱肿瘤电切术（BL-TURB）进行光动力诊断可能会降低非肌层浸润性膀胱癌的复发风险，因为其肿瘤检测更敏感。在这项真实世界数据分析中，评估了初始使用WL-TURB与BL-TURB对后续成本的影响。
在主要和调整后的研究人群中分析了2011年至2016年德国法定医疗保险（GKV）的匿名理赔数据。选择标准包括入组前的五个季度、初始TURB和膀胱癌诊断的一个索引季度（InQ），主要分析在两年内，调整分析在四年内，以及分别为11个或3个季度的随访期（FU）。
在主要分析（n = 2331）中，膀胱切除术被确定为掩盖队列间潜在差异的重要成本驱动因素。因此，接受膀胱切除术（InQ + FU）的患者被排除在n = 4541例患者的调整后研究人群之外（WL：79%；BL：21%）。BL-TURB的平均总成本最初与WL-TURB相当（WL：4534欧元 vs. BL：4543欧元），并且在FU的前两个季度与WL-TURB相比有降低趋势。一年后（第3个FU季度），成本趋于平衡。考虑整个FU期，BL-TURB的平均成本显著低于WL-TURB（WL：7073欧元 vs BL：6431欧元；p = 0.045）。
这项对医疗理赔数据的回顾性分析突出了BL-TURB和WL-TURB之间成本的可比性。
