New Procedures are Bound to Modify Our Attitude in Facing Urologic Cancers in the Near Future: Are We Ready for a Cost-Effectiveness Analysis?

摘要

During the last decade, requests for high-cost medical procedures for human cancer diagnosis and treatment have increased dramatically. However, the economic funds of public health systems have been recognised as limited. As a consequence, one of the most critical points emerging, when considering new therapeutic approaches, is represented by an analysis of their cost effectiveness. This is certainly true for all urologic cancers and especially when considering non-muscle invasive (Ta,Tl) transitional cell carcinoma of the bladder and carcinoma in situ (CIS), because of its extremely high prevalence. In addition, particularly in this field, many implementations in laboratory, pathology, and technologic systems have been developed, tested, and clinically applied. This has resulted in a number of new markers and novel therapeutic procedures that are actually improving our ability to manage this disease. Because both the safety and reliability of all these new procedures have been supported by published rigorous clinical trials, we should start considering them in our routine decision-making. This fact, in addition to the marketing pressure and penetration, as well as the patient's understandable request, require a complete re-evaluation of current therapeutic algorithms. Therefore, only procedures with a favourable cost-effective analysis can be sustained by the public health care providers, thus allowing for their diffusion.