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BACKGROUND: More than 120,000 people are diagnosed annually with bladder cancer in the 28 countries of the European Union (EU). With >40,000 people dying of it each year, it is the sixth leading cause of cancer. However, to date, no systematic cost-of-illness study has assessed the economic impact of bladder cancer in the EU. OBJECTIVE: To estimate the annual economic costs of bladder cancer in the EU for 2012. DESIGN, SETTING, AND PARTICIPANTS: Country-specific cancer cost data were estimated using aggregate data on morbidity, mortality, and health care resource use, obtained from numerous international and national sources. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Health care costs were estimated from expenditures on primary, outpatient, emergency, and inpatient care, as well as medications. Costs of unpaid care and lost earnings due to morbidity and early death were estimated. RESULTS AND LIMITATIONS: Bladder cancer cost the EU €4.9 billion in 2012, with health care accounting for €2.9 billion (59%) and representing 5% of total health care cancer costs. Bladder cancer accounted for 3% of all cancer costs in the EU (€143 billion) in 2012 and represented an annual health care cost of €57 per 10 EU citizens, with costs varying >10 times between the country with the lowest cost, Bulgaria (€8 for every 10 citizens), and highest cost, Luxembourg (€93). Productivity losses and informal care represented 23% and 18% of bladder cancer costs, respectively. The quality and availability of comparable cancer-related data across the EU need further improvement. CONCLUSIONS: Our results add to essential public health and policy intelligence for delivering affordable bladder cancer care systems and prioritising the allocation of public research funds. PATIENT SUMMARY: We looked at the economic costs of bladder cancer across the European Union (EU). We found bladder cancer to cost €4.9 billion in 2012, with health care accounting for €2.9 billion. Our study provides data that can be used to inform affordable cancer care in the EU.

Original publication




Journal article


Eur Urol

Publication Date





438 - 447


Bladder cancer, Cancer, Cost of illness, European Union, Ambulatory Care, Antineoplastic Agents, Cost of Illness, Drug Costs, Emergency Medical Services, Europe, European Union, Health Care Costs, Health Expenditures, Health Resources, Healthcare Disparities, Hospital Costs, Humans, Time Factors, Urinary Bladder Neoplasms