{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T10:53:26Z","timestamp":1779879206812,"version":"3.53.1"},"reference-count":26,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2014,4,18]],"date-time":"2014-04-18T00:00:00Z","timestamp":1397779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2014,8,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Sequential bacillus Calmette\u2010Guerin (BCG) and electromotive mitomycin (sequential therapy) have been shown in a randomized prospective trial to be superior to therapy with BCG alone in patients with high\u2010risk non\u2013muscle\u2010invasive bladder cancer. The objective of the current study was to compare the costs and benefits of these 2 treatment strategies by performing a 5\u2010year and 10\u2010year cost\u2010effectiveness study.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A Markov model was developed to estimate the incremental cost\u2010effectiveness ratio over a 5\u2010year and 10\u2010year period. Estimates of disease progression, death, and treatment efficacy were obtained from what to the authors' knowledge is the only randomized trial comparing the 2 therapies. Costs included: 1) medical costs (physician fees); 2) drug costs (preparation and instillation); and 3) hospital costs (procedure fees, admission fees, and tests and procedures done during surveillance). Patients were allowed a second course of induction therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Sequential therapy was found to be associated with a higher initial material cost for induction and maintenance. The average effectiveness for the patients treated with therapy with BCG alone was 4.39 years with a mean cost of $9236 (95% confidence interval, $9118\u2010$9345) per patient. The sequential group resulted in an average effectiveness of 4.65 years, with a mean cost of $16,468 (95% confidence interval, $16,371\u2010$16,527). The 5\u2010year incremental cost\u2010effectiveness ratio of sequential versus BCG\u2010alone therapy was $27,815 per life\u2010year gained. The corresponding figure over a 10\u2010year period was $8618 per life\u2010year gained.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The results of the current study suggest that sequential therapy is a cost\u2010effective treatment for patients with high\u2010risk non\u2013muscle\u2010invasive bladder cancer. <jats:bold><jats:italic>Cancer<\/jats:italic> 2014;120:2424\u20132431.<\/jats:bold> \u00a9 <jats:italic>2014 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.28731","type":"journal-article","created":{"date-parts":[[2014,4,19]],"date-time":"2014-04-19T06:40:23Z","timestamp":1397889623000},"page":"2424-2431","source":"Crossref","is-referenced-by-count":19,"title":["Contemporary cost\u2010effectiveness analysis comparing sequential bacillus Calmette\u2010Guerin and electromotive mitomycin versus bacillus Calmette\u2010Guerin alone for patients with high\u2010risk non\u2013muscle\u2010invasive bladder cancer"],"prefix":"10.1002","volume":"120","author":[{"given":"Bassel G.","family":"Bachir","sequence":"first","affiliation":[{"name":"Division of Urology, Department of Surgery McGill University Health Center Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Dragomir","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery McGill University Health Center Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armen G.","family":"Aprikian","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery McGill University Health Center Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Tanguay","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery McGill University Health Center Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Fairey","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Faculty of Medicine University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish S.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University Health Network, University of Toronto Toronto Ontario Canada"},{"name":"Institute for Clinical and Evaluative Sciences, University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney H.","family":"Breau","sequence":"additional","affiliation":[{"name":"Division of Urology, Clinical Epidemiology Ottawa Hospital Research Institute Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Black","sequence":"additional","affiliation":[{"name":"Department of Urologic Sciences University of British Columbia Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wassim","family":"Kassouf","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery McGill University Health Center Montreal Quebec Canada"},{"name":"McGill Urology Residency Program Director McGill University Health Center Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.06.003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(05)70472-1"},{"key":"e_1_2_7_4_1","volume-title":"Decision Making in Health and Medicine: Interpreting Evidence and Values","author":"Hunink MG","year":"2001"},{"key":"e_1_2_7_5_1","first-page":"473","article-title":"How attractive does a new technology have to be to warrant adoption and utilization&quest; Tentative guidelines for using clinical and economic evaluations","volume":"146","author":"Laupacis A","year":"1992","journal-title":"CMAJ"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)67707-5"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040284"},{"key":"e_1_2_7_8_1","unstructured":"Ministere de la Sante et des Services Sociaux. 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