The cost of bladder tumour treatment and follow-up

OBJECTIVE: To evaluate the costs of bladder tumour treatment and follow-up. MATERIAL AND METHODS: The incidence of bladder tumours, both new and recurrences, and the cost of bladder tumour treatments with curative intent were registered during a 4-year period (1994-97). RESULTS: The incidence of new tumours varied from year to year, in contrast to the number of recurrent tumours, which remained remarkably stable. The total cost of bladder cancer diagnosis, treatment and follow-up was almost 7,000,000 SEK per year (2,800,000 SEK per 100,000 inhabitants per year). The number of therapeutic events per year remained stable at 256 +/- 17 (102 per 100,000 inhabitants per year). Cystectomies were responsible for 34% of the expenditure and transurethral procedures for 40%. Follow-up cystoscopies accounted for only 13% of the total cost. One-third of the routine follow-up cystoscopies resulted in a therapeutic procedure. The cost of transurethral resections and extirpations was approximately five times higher when performed with the patient hospitalized compared to when performed as day-care surgery. CONCLUSIONS: A reduction in the number of follow-up cystoscopies will only produce marginal economic savings. Further savings could be made if more transurethral resections and extirpations/fulgurations were performed on an outpatient basis. Another important goal is to reduce the median cost per cystectomy.