Approximation of expenditure in the hospital sector to the statutory health insurance and an overview of relevant expenditure components in the outpatient sector for bladder cancer care

Background: Bladder cancer, the most common type of urinary tract cancer is newly diagnosed in ˜28,750 men and women every year in Germany, with smoking being the most established risk factor. It is the 4th most common cancer in men and 11th most common in women; men are three times more likely to be diagnosed. 'In most cases bladder cancer is a chronic disease that is not life-threatening. For healthcare economists this cancer should be of utmost priority for its cost. Bladder cancer is the most expensive cancer to treat incurring the highest per person (pp) lifetime treatment costs. It is estimated, depending on country, that the pp cost to treat BC from diagnosis to death ranges between $ 89,287 (€64.69M) and $202,203 (€146.5M) and increases with increasing survival rates. Methods: To examine the cost of bladder cancer in Germany, an analysis of the G- DRG system was conducted, allowing an understanding of the costs incurred within the hospital sector and of the diagnoses and procedures driving the cost categories. Findings: Approximately 69,781 patients were treated in 2007 for malignancies of the bladder. The total cost incurred within the primary station reached €196.6 million; an additional €5.49 million was spent within the physicians attending section of the hospital. The most common procedures were TURs (82%), the most expensive procedures from a pp perspective were cystectomy and bladder replacements. Discussion: Key contributors for enormous costs are the high recurrence rates and ongoing monitoring requirements. More accurate treatment tools are needed to prevent disease progressing at which more costly surgeries become necessary; educating the public about this cancer and limiting smoking aids in containing cost.