Urology Research: How the Utilization of BCG for Nonmuscle Invasive Bladder Cancer Changed During a 2021 Shortage


Daniel Lee, MD, MS, University of Pennsylvania

The following real-world data analysis of the American Urological Association AUA Quality Registry (AQUA) was featured in the February 2021 issue of AUANews. More real-world urologic research leveraging the AQUA network of more than 2,000 healthcare providers, nearly 10 million patients, and 8 years of longitudinal data can be found here.

AQUA Verana Health Analysis of AQUA Registry Data Provides Insights into the Evolving Urologic Practice

By: Daniel Lee, MD, MS, University of Pennsylvania Health System, Philadelphia

Primary Question: How Has the Utilization of Bacillus Calmette-Guerin (BCG) for the Treatment of Nonmuscle Invasive Bladder Cancer Changed since the BCG Shortage?

BCG is considered the gold standard and front-line therapy for high grade nonmuscle invasive bladder cancer. In January 2019, Merck announced severe shortages in the supply of BCG.

In cooperation with Verana Health, we sought to evaluate the impact of the BCG shortage on utilization of BCG within urology practices in the United States. Using the AUA Quality (AQUA) Registry and analyzing 72 practices from March 20, 2018, to January 20, 2020, we found a dramatic decrease in BCG utilization nationwide.

There was a 66.9% decrease in BCG utilization after the release of the notice. Although this change may represent a decrease in inappropriate use of BCG (ie, for low-grade disease), this large percentage drop is quite concerning for what is considered the gold standard and first line treatment for nonmuscle invasive bladder cancer.

We hope to investigate this trend further by analyzing how it compares with the utilization of other intravesical agents.

Verana Health is the data and technology partner for the AQUA Registry. Verana Health partners with leading medical associations to transform clinical data into actionable real-world evidence. These partnerships enable Verana to harness the comprehensive data found in qualified clinical data registries and other specialty data sources to accelerate medical research and enhance patient care. Learn more at www.veranahealth.com.

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