{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T05:34:52Z","timestamp":1792128892510,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare intravesical gemcitabine\/docetaxel (Gem\/Doce) vs standard\u2010of\u2010care bacillus Calmette\u2013Gu\u00e9rin (BCG) in intermediate\u2010\/high\u2010risk non\u2010muscle\u2010invasive bladder cancer (NMIBC), as patient\u2010reported physical\u2010psychological quality of life (QoL) and cost\u2010effectiveness estimation are pivotal to evaluate adjuvant intravesical treatments yet are rarely evaluated head\u2010on.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>In a prospective per\u2010protocol analysis (Gem\/Doce 39 patients; BCG 44 patients), survival endpoints (recurrence\u2010free survival [RFS], progression\u2010free survival [PFS]) and National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE)\u2010graded adverse events (AEs) were recorded. QoL was assessed at baseline, post\u2010induction, and at 6 and 12\u2009months using the European Organisation for Research and Treatment of Cancer Quality\u2010of\u2010Life Questionnaire\u201030\u2010item core (EORTC QLQ\u2010C30) and 24\u2010item QLQ\u2010NMIBC (QLQ\u2010NMIBC24) and mapped to the EuroQoL five Dimensions five Levels (EQ\u20105D\u20105L) using an Indian tariff to estimate quality\u2010adjusted life years (QALYs). Direct medical costs were recorded, and incremental cost\u2010effectiveness ratios (ICERs) were calculated per QALY and recurrence\/progression outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients receiving Gem\/Doce achieved higher 1\u2010year RFS (94.74% vs 75%, hazard ratio 0.44;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.02) and PFS (100.00% vs 93.19%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.09). The AEs were fewer with Gem\/Doce (12.82% vs 34.10%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.028); Grade 3 events occurred only with BCG (4.65%). Gem\/Doce showed significantly higher global health, physical\/role\/emotional functioning and sexual health scores at 6\u201312\u2009months, with reduced fatigue, urinary symptoms and intravesical\u2010treatment problems. Mean QALYs improved with Gem\/Doce (0.8807 vs 0.7198), and with an ICER of \u20b9504\u2009000 Indian Rupees ($6072 United States Dollars) per QALY \u2013 well within India's willingness\u2010to\u2010pay threshold and far below international benchmarks. Additional gains included +1.38 recurrence\u2010free months overall and +2.82 in high\u2010risk patients, achieved at acceptable incremental cost, indicating pragmatic cost profile against avoided recurrences and QoL gains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sequential Gem\/Doce delivered optimal short\u2010term survival outcomes, favourable patient\u2010reported QoL and safety profile, and attractive cost per avoided recurrence\/progression compared with BCG, supporting its adoption as a clinically and economically viable alternative in resource\u2010constrained NMIBC care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70126","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T04:35:31Z","timestamp":1766550931000},"page":"639-649","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Quality of life and cost\u2010effectiveness of intravesical gemcitabine\/docetaxel vs\n                    <scp>BCG<\/scp>\n                    in\n                    <scp>BCG<\/scp>\n                    \u2010na\u00efve non\u2010muscle\u2010invasive bladder cancer"],"prefix":"10.1111","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7852-8556","authenticated-orcid":false,"given":"Aviral","family":"Srivastava","sequence":"first","affiliation":[{"name":"Department of Urology, Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8308-9220","authenticated-orcid":false,"given":"Sameer","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ujwal","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9531-6386","authenticated-orcid":false,"given":"Yashasvi","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalit","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahil","family":"Data","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satya Narayan","family":"Sankhwar","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Medical Sciences Banaras Hindu University  Varanasi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"https:\/\/gco.iarc.fr\/today\/data\/factsheets\/populations\/356\u2010india\u2010fact\u2010sheets.pdf"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.21037\/tau-20-1333"},{"key":"e_1_2_11_4_1","unstructured":"https:\/\/cancerrounds.com\/costs\/bladder\u2010cancer\u2010india\/"},{"key":"e_1_2_11_5_1","unstructured":"EAU Guidelines. 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