“Bladder cancer is associated with high treatment costs. A significant portion of cost is related to the high rates of cancer recurrence. In our study, utilization of BLC in the management of NMIBC was associated with modestly higher healthcare costs compared to white light. However, the majority of cost was related to increased use of guideline recommended intravesical therapy in the BLC cohort due to early detection of tumor. Early detection facilitated by BLC, appropriate intravesical therapy, and reduced recurrence significantly narrowed the cost differential that approached net cost neutrality compared to WL while providing superior clinical outcomes. These findings provide real-world cost data to aid in the decision-making process for utilizing BLC particularly in the care of high-risk NMIBC patients,” said Dr. Steven Williams, Professor and Chief of the Division of Urology, at the University of Texas-Medical Branch, and one of the study authors.The BRAVO study (Bladder Cancer Recurrence Analysis in Veterans and Outcomes) is a propensity score matched, retrospective analysis evaluating outcomes following BLC compared to WLC alone in 622 patients from the Veterans Affairs Healthcare System. The primary objective was to determine the difference in total healthcare costs over 1, 2, and 5-year intervals with available cost data. A cost-offset analysis was performed addressing multiple aspects of BLC healthcare costs including the financial impacts of recurrence avoidance. The Veterans’ Affairs (VA) Healthcare system accepts all U.S. Veterans, regardless of financial background, and retains its patients, allowing for high-quality data capture over a long-term follow-up period, therefore serving as a robust real-world model for equal access.
Results:
- BLC vs. WLC patients were more likely to receive intravesical BCG (61 vs 43%; p<0.01) and intravesical chemotherapy (49% and 28%, p<0.01), respectively.
- BLC use was associated with decreased risk or recurrence (HR 0.62, p<0.01)
- Initial total costs over 5 years were higher in the BLC group ($108,411 vs $66,734; p<0.01), with outpatient costs being the main driver ($90,788 vs $55,529; p<0.01).
- A cost-offset analysis showed that the 5-year costs of BLC exposure were only $721 more per person versus WLC due to shorter hospital stays, fewer emergency visits, and fewer recurrence events.
- Conclusions: In a real-world equal-access setting, initial 5-year total costs for BLC were higher, mostly driven by outpatient costs likely related to increased utilization of intravesical therapies and closer surveillance in BLC patients. However, given lower recurrence rates with BLC and accounting for the costs of treating recurrence, the adjusted cost difference approaches net neutral.
Source: Photocure ASA. (2025). The Impact of Avoiding Recurrence: New BRAVO Study Abstract at SUO 2025 Demonstrates Cost Neutrality in Blue Light Versus White Light Cystoscopy Comparison [Press release]. https://photocure.com/newsletters/news-from-photocure-5268781?utm_source=email&utm_medium=email_campaign&utm_campaign=newsletter.
Related Content:
SUO 2025: Costs of Care and Oncologic Outcomes Associated with Blue Light Cystoscopy in an Equal Access Setting: Results from the BRAVO Study