Healthcare costs in relation to increased use of preoperative renal tumour biopsies

Authors

  • Agnes Lind Department of Learning, Informatics, Management and Ethics, Karolinska Institute; Stockholm Center for Health Economics, Center for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Healthcare Services, Stockholm, Sweden
  • Bassam Mazin Hashim Department of Urology, Region Västmanland – Uppsala University, Center for Clinical Research, Västmanland Hospital, Västerås, Sweden https://orcid.org/0009-0006-8775-9774
  • Matilda Hagman Department of Learning, Informatics, Management and Ethics, Karolinska Institute; Stockholm Center for Health Economics, Center for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Healthcare Services, Stockholm, Sweden
  • Susanna Holst Department of Radiology, Skånes University Hospital, Malmö, Sweden
  • Andreas Karlsson Rosenblad Regional Cancer Centre Stockholm-Gotland, Region Stockholm, Stockholm, Sweden; Department of Statistics, Uppsala University, Uppsala, Sweden; Department of Medical Sciences, Division of Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institute, Stockholm, Sweden https://orcid.org/0000-0003-3691-8326
  • Börje Ljungberg Department of Diagnostics and Intervention, Urology and Andrology, Umeå University, Umeå, Sweden https://orcid.org/0000-0002-4121-3753
  • Per-Olof Lundgren Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden https://orcid.org/0000-0001-7976-6962
  • Sven Lundstam Departments of Urology and Oncology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  • Camilla Nystrand Department of Learning, Informatics, Management and Ethics, Karolinska Institute; Stockholm Center for Health Economics, Center for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Healthcare Services, Stockholm, Sweden https://orcid.org/0000-0003-4543-3398
  • Fanny Goude Department of Learning, Informatics, Management and Ethics, Karolinska Institute; Stockholm Center for Health Economics, Center for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Healthcare Services, Stockholm, Sweden https://orcid.org/0000-0001-6575-7563
  • Tobias Lauritsen Department of Learning, Informatics, Management and Ethics, Karolinska Institute; Stockholm Center for Health Economics, Center for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Healthcare Services, Stockholm, Sweden

DOI:

https://doi.org/10.2340/sju.v60.43194

Keywords:

Renal tumour biopsy, economic impact, budget impact, economic evaluation, small renal mass, percutaneous renal biopsy, renal cell carcinoma

Abstract

Objective: To analyse the budget impact of adopting routine renal tumour biopsy (RTB) prior to decision on surgical treatment for clinical T1 renal tumours in Sweden.

Material and methods: This study used data from the National Swedish Kidney Cancer Register including 4,109 T1N0M0 renal tumours surgically treated during the years 2018–2022. We modelled a gradual increase in the proportion of preoperative RTBs over a five-year period, from 15.6 % of surgically removed clinical T1N0M0 renal tumors up to 90 % preoperative RTBs by 2029. Average costs per patient were calculated primarily using the Swedish cost-per-patient database. The analyses were stratified by tumour diameter: ≤40 mm (cT1a) and 41–70 mm (cT1b). The proportion of patients with benign RTB, complication rate and false negative RTBs was estimated from register data and previous research. A healthcare perspective was used and accounted for costs related to biopsy, surgery, follow-up of benign RTBs, complications and re-biopsy in cases of inconclusive RTBs.

Results: For cT1a, increasing preoperative RTBs to 90% of the study population reduced the net annual costs by €691,620, whilst for cT1b, costs increased by €67,630. Overall, an increase in preoperative RTBs to 90% of all patients with cT1 renal tumours was projected to reduce spending by €623,990 annually.

Conclusions: The budget impact analysis of routine preoperative RTBs in suspected renal cell carcinoma indicates net healthcare cost savings in cT1a and potentially for all cT1 tumours.

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References

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Published

2025-03-13

How to Cite

Lind, A., Mazin Hashim, B., Hagman, M., Holst, S., Karlsson Rosenblad, A., Ljungberg, B., … Lauritsen, T. (2025). Healthcare costs in relation to increased use of preoperative renal tumour biopsies. Scandinavian Journal of Urology, 60, 66–72. https://doi.org/10.2340/sju.v60.43194

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Vol. 60 (2025)

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Copyright (c) 2025 Agnes Lind, Bassam Mazin Hashim, Matilda Hagman, Susanna Holst, Andreas Karlsson Rosenblad, Börje Ljungberg, Per-Olof Lundgren, Sven Lundstam, Camilla Nystrand, Fanny Goude, Tobias Lauritsen

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As from Volume 59 (2024) all published articles, unless otherwise specified, are published under CC-BY license, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, with the condition of proper attribution to the original work. 

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