Longitudinal Economic Burden for Non–Muscle-Invasive Bladder Cancer by EAU Progression Risk Groups Using the Prospective Multicenter COBLAnCE Cohort Linked to the French National Healthcare System Database

Background Data on longitudinal bladder cancer (BC) costs are scarce. Objective To assess the economic burden of non–muscle-invasive bladder cancer (NMIBC) by progression risk groups in France over a 1-yr and 5-yr time horizon after initial diagnosis. Design, setting, and participants We used data from the French national prospective COhort to study BLAdder CancEr (COBLAnCE) cohort. A total of 1101 patients diagnosed with a primary NMIBC between 2012 and 2018 were linked with the French National Healthcare System Database. Patients were classified into four risk groups according to the 2021 European Association of Urology risk stratification. Resources used included all BC-related hospitalizations, follow-up visits to urology and oncology clinics and related prescriptions, BC-related imaging procedures, transportation, and sick leaves. Costs were estimated from the perspective of the French health care system over the 5 yr after BC diagnosis. Outcome measurements and statistical analysis Across risk groups, mean per-patient cost ranged from €5838 to €20 678 and €11 697 to €40 519 over 1 yr and 5 yr, respectively. Surgical hospital stays accounted for 60% of costs in the first year. Over 5 yr, intravesical treatments, surveillance visits, and imaging were major cost drivers, especially among patients at lower risk of progression. Results and limitations Although claims databases are comprehensive, the economic burden of NMIBC may be underestimated owing to potential incomplete coding. Conclusions To our knowledge, this is the first national cohort study to provide robust cost estimates for patients with NMIBC stratified according to progression risk groups. These real-world data are particularly awaited for the economic evaluation of emerging treatments in patients with NMIBC.