Economics of urinary tract cancers: state of the art.

The guiding principles of the predominant methods of economic evaluation, cost-effectiveness analysis and cost-utility analysis, are briefly outlined, stressing the usefulness of the methods as a systematic approach to a structured and consistent analysis of decision problems, e.g. involving choices between treatment alternatives. The paper continues with an assessment of state of the art of economic evaluations of urinary tract cancers, based on a comprehensive survey of the available publications, which are limited to bladder cancer and advanced prostate cancer. Following a description of the methods employed in the relatively few existing studies and their results, it is concluded that they are of very dubious value in providing reliable guidance on the relative costs and benefits of treatment alternatives, as they are very rudimentary and usually based on data of low quality. Considering the high and growing incidence of both prostate and bladder cancer, there is an urgent need for economic assessment of a high methodological standard and based on data of a good quality.