Lotan - Figure 27
Bladder marker alternating every three months with cystoscopy/cytology
FIG. 27: Several studies have evaluated the potential for using a bladder marker alternating with cystoscopy and cytology every 3 months.[15,16] Both studies used modeling approaches. One of them[15] used a marker with a fairly conservative performance (sensitivity 50%, specificity 70%) and found cost savings as high as $400-500 per patient per year, but this was cost effective only if the marker used was relatively cheap, ie, costing less than $264.
Another analysis using a higher performance marker[16] found more modest cost savings during the first 6 months, with one less cystoscopy performed in about two-thirds of patients, but with a 3-month delay in diagnosis of recurrence in about 9% of patients.
References
Lotan Y, Roehrborn CG. Cost-effectiveness of a modified care protocol substituting bladder tumor markers for cystoscopy for the followup of patients with transitional cell carcinoma of the bladder: a decision analytical approach. J Urol. 2002;167:75−9 http://dx.doi.org/10.1016/S0022-5347(05)65386-4
Lachaine J, Valiquette L, Crott R. Economic evaluation of NMP22 in the management of bladder cancer. Can J Urol. 2000;7:974−80
