The Impacts of Bladder Cancer on UK Healthcare Costs and Patients' Health-Related Quality of Life: Evidence from the BOXIT Trial: Bladder cancer cost and health-related impacts

Edward Miles Cox, Pedro Rafael Saramago Goncalves, John Kelly, Nuria Porta, Emma Hall, Wei Shen Tan, Mark Sculpher, Marta O Soares

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Background: Limited evidence exists regarding the cost and health-related quality of life (HRQoL) impacts of non-muscle invasive bladder cancer (NMIBC) recurrence and progression to muscle invasive bladder cancer (MIBC). We examined these impacts using evidence from a recent randomised control trial.

Material and Methods: Costs and HRQoL associated with bladder cancer were assessed using data from the Bladder COX-2 Inhibition Trial (BOXIT) (n=472). Cost and HRQoL impacts from clinical events were estimated using generalised estimating equations. Costs were derived from recorded resource usage and UK unit costs. HRQoL was assessed using the EQ-5D-3L with published UK preference tariffs. Events were categorised by TMN classification.

Results: Grade 3 recurrences and progressions were associated with statistically significant -0.08 (95% confidence interval -0.13, -0.03) and -0.10 (-0.17, -0.03) HRQoL decrements, respectively. The three year average cost per NMIBC patient was estimated at £8,735 (£8,325, £9,145) with grade 1, 2 and 3 recurrences associated with annual cost impacts of £1,218 (£403, £2033), £1,677 (£920, £2433) and £3,957 (£2,332, £5,583), respectively, and £5,407 (£2,663, £8,152) for a progression to MIBC.

Conclusion: Evidence from the BOXIT trial suggests NMIBC patients will incur both decrements in HRQoL and significant costs, especially in the event of a grade 3 recurrence or a progression to MIBC.
Original languageEnglish
Pages (from-to)1-44
Number of pages44
JournalClinical Genitourinary Cancer
Publication statusPublished - 13 Dec 2019

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© 2019 The Author(s). Published by Elsevier Inc.

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