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Area of Science:

  • Urology
  • Oncology
  • Public Health

Background:

  • Non-muscle invasive bladder cancer (NMIBC) management often relies on intravesical therapies.
  • Bacillus Calmette-Guerin (BCG) is a primary treatment for high-risk NMIBC.
  • BCG shortages can impact treatment accessibility and clinical practice.

Purpose of the Study:

  • To analyze trends in intravesical agent use for NMIBC during BCG shortages.
  • To assess changes in treatment patterns following documented BCG supply disruptions.

Main Methods:

  • Retrospective analysis of SEER-Medicare data (2005-2015).
  • Inclusion of 24,410 patients diagnosed with NMIBC.
  • Interrupted time series analysis to evaluate treatment trends before and during BCG shortages (2012, 2014).

Main Results:

  • BCG treatment probability remained stable after the initial 2012 BCG shortage.
  • A statistically significant decrease of 0.072 in BCG treatment probability was observed after the 2014 shortage.
  • This decreased trend in BCG use persisted post-shortage.

Conclusions:

  • Intravesical agent use for NMIBC was largely unaffected by the first BCG shortage.
  • The second BCG shortage led to a modest but sustained reduction in BCG treatment probability.
  • Further research is needed to evaluate the oncologic outcomes associated with these treatment shifts.