Abstract
BackgroundUrothelial bladder cancer (UBC) is the 5th most common cancer in Western societies. The most common symptom of UBC is haematuria. Cystoscopy the gold standard for UBC detection, allows direct observation of the bladder, but is expensive, invasive, and uncomfortable. This study examines whether an alternative new urine-based diagnostic test, the DCRSHP, is cost-effective as a triage diagnostic tool compared to flexible cystoscopy in the diagnosis of UBC in haematuria patients.MethodsA model-based cost-utility analysis using cost per quality adjusted life year and life year gained, parameterised with secondary data sources.ResultsIf the DCRSHP is targeted at haematuria patients at lower risk of having bladder cancer e.g. younger patients, non-smokers, then it can be priced as high as £620, and be both effective and cost-effective. Sensitivity analysis found that DCRSHP is approximately 80% likely to be cost-effective across all willingness to pay values (for a QALY) and prevalence estimates.ConclusionThis analysis shows the potential for a non-invasive test to be added to the diagnostic pathway for haematuria patients suspected of having UBC. If the DCRSHP is applied targeting haematuria patients at low risk of UBC, then it has the potential to be both effective and cost-effective.
Highlights
Urothelial bladder cancer (UBC) is the 5th most common cancer in Western societies
If the DCRSHP is targeted at haematuria patients at lower risk of having bladder cancer e.g. younger patients, non-smokers, it can be priced as high as £620, and be both effective and cost-effective
This does not alter our adherence to PLOS ONE policies on sharing data and materials. This analysis shows the potential for a non-invasive test to be added to the diagnostic pathway for haematuria patients suspected of having UBC
Summary
Using a decision analytic model, the objective of this study was to examine the cost-effectiveness of the DCRSHP biochip as a triage diagnostic test compared with flexible cystoscopy in the diagnosis of bladder cancer in haematuria patients
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