title: Hexaminolevulinate hydrochloride blue-light flexible cystoscopy in the detection and follow-up of nonmuscle-invasive bladder cancer: cost consequences during outpatient surveillance in Sweden.
abstract: OBJECTIVE
  This study explored the cost consequences of introducing hexaminolevulinate hydrochloride-guided blue-light flexible cystoscopy (HAL BLFC) as an adjunct to white-light flexible cystoscopy compared with white-light flexible cystoscopy alone, for the detection and management of nonmuscle invasive bladder cancer in Sweden.
  
  
  METHODS
  The model evaluated 231 patients in the outpatient setting after successful initial transurethral resection of the bladder tumor.
  
  
  RESULTS
  HAL BLFC introduction across all risk groups resulted in minimal budget impact (+1.6% total cost/5 years, or 189 Swedish Krona [SEK] per patient/year), and translated to cost savings in intermediate- and high-risk groups from year 2.
  
  
  CONCLUSIONS
  HAL BLFC allowed more outpatient treatment with improved recurrence detection and reduced transurethral resection of the bladder tumors, cystectomies, bed days and operating room time, with minimal cost impact across all risk groups, demonstrating the economic benefits of introducing HAL.
authors.affiliation: HERON™ Commercialization, PAREXEL, Stockholm, Sweden.
authors.forename: Viktor
authors.initials: V
authors.lastname: Dansk
authors.affiliation: Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Per-Uno
authors.initials: PU
authors.lastname: Malmström
authors.affiliation: Department of Urology & Surgery, Helsingborg Hospital, Helsingborg, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Bläckberg
authors.affiliation: HERON™ Commercialization, PAREXEL, Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Malmenäs
mesh_terms: D000622:Aminolevulinic Acid / Q000031:analogs & derivatives*; D003365:Costs and Cost Analysis; D015653:Cystectomy; D003558:Cystoscopy / Q000191:economics / Q000379:methods*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008027:Light; D008390:Markov Chains; D009367:Neoplasm Staging; D010045:Outpatients; D011159:Population Surveillance; D012008:Recurrence; D013548:Sweden / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy
chemical_list: D000622:Aminolevulinic Acid; C419924:5-aminolevulinic acid hexyl ester
keywords: Sweden; bladder cancer; budget impact; cost-consequences model; detection; economic evaluation; fluorescence cystoscopy; fulguration; hexaminolevulinate; recurrence