Bladder cancer is one of the most expensive malignant neoplasms to manage on a per-patient basis. 1 Approximately 70% of patients with newly diagnosed bladder cancer present with non-muscleinvasive bladder cancer (NMIBC). Non-muscle-invasive bladder cancer is a heterogeneous disease that leads to significant variability in the intensity of surveillance and treatments to decrease the risk of local recurrences and progression to more invasive disease. National guidelines advocate for riskadapted

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... urveillance and treatment in this patient population. 2 High-risk NMIBC carries the highest risk of recurrence and progression. The financial costs associated with the treatment of high-risk NMIBC arise from frequent cystoscopic surveillance, adjunct testing (eg, urine cytology), periodic cross-sectional imaging, intravesical treatments (eg, bacillus Calmette-Guérin [BCG] therapy), transurethral resections of bladder tumor (TURBT) under general anesthesia, and definitive treatments for progression to muscle-invasive disease (eg, radical cystectomy). Recent publications quantifying the costs of care for this group with high-risk NMIBC have demonstrated that the most significant costs incurred are owing to disease progression and subsequent definitive treatments. 3