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. 2019 Jan;58(1):34-40.
doi: 10.1007/s00120-018-0624-4.

[Cost-effectiveness analysis of blue light cystoscopy with hexylaminolevulinate in transurethral resection of the bladder]

[Article in German]
G Gakis  1 , B Volkmer  2 , B Qvick  3 , F Marteau  4 , A Stenzl  5
Affiliations

[Cost-effectiveness analysis of blue light cystoscopy with hexylaminolevulinate in transurethral resection of the bladder]

[Article in German]
G Gakis et al. Urologe A. 2019 Jan.

Abstract

Background: Photodynamic diagnosis using the optical imaging agent hexaminolevulinate (HAL, Hexvix®, Ipsen Pharma GmbH, Ettlingen, Germany) as an adjunct to white light cystoscopy (WLC) during the initial transurethral resection of bladder tumours (TURB) improves the detection rate of bladder cancer and leads to fewer recurrences.

Objectives: A cost-effectiveness analysis was carried out in order to calculate the consequences for the German healthcare system.

Methods: We combined a short-term decision tree and a Markov model to evaluate outcomes over a long period of time. The alternatives investigated were HAL-assisted blue light cystoscopy (BLC) as adjunct to WLC (HAL + BLC/WLC) compared with WLC alone in patients undergoing TURB.

Results: HAL + BLC/WLC compared to WLC alone was associated with 0.07 incremental quality-adjusted life years (QALYs) and cost savings of 537 € per patient.

Conclusion: HAL + BLC/WLC compared with WLC alone resulted in both cost savings and improved patient outcome rendering it the "dominant" strategy.

Keywords: Bladder cancer; Cost-effectiveness; Hexaminolevulinate; Markov model; Photodynamic diagnosis.

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