Comparing Protracted Infusion of Low Dose Gemcitabine Versus Short Infusion Conventional Dose Gemcitabine in Treatment Bilharzial Bladder Cancer, A Cost-Effectiveness Study

Purpose: Comparison between protracted six hours infu-sion 250mg/m2 gemcitabine plus cisplatin and conventional one hour infusion 1000mg/m2 gemcitabine plus cisplatin, cost-effectiveness in treatment Bilharzial related bladder cancer. This was achieved by comparing and review of the response rate, toxicity profile, as well as the cost of treatment to prove which regimen is more cost effective.Patients and Methods: In this retrospective study, 55 patients received protracted six hours infusion 250mg/m2 gemcitabine plus cisplatin while 33 patients received conven-tional one hour infusion 1000mg/m2 gemcitabine plus cisplatin.Data collected for each patient included: Treatment method and treatment complications, clinical evaluation, response rate, and toxicity profile, cost of medical devices used, medical team time cost, hospitalization cost and supportive treatment, and the total cost of treatment.Results: This study showed that protracted gemcitabine infusion regimen was more cost effective than conventional one hour gemcitabine infusion regimen. The average total cost of treatment for protracted regimen was 1614.22 Egyptian pounds while the average total cost of conventional regimen was 3275.04 Egyptian pounds, a highly significant difference with p value = 0.0000. Generally, there were no significant differences between the two therapies in overall response or the incidence of overall toxicity with highly significant difference between the total costs of the two therapies.Conclusion: This study showed a highly significant difference in the total cost, proving that protracted gemcitabine infusion regimen is more cost-effective than conventional one hour gemcitabine infusion regimen with no difference in overall response, or toxicity profile.