Costs, Innovation, And Change Management

In this issue of the CUAJ, we feature several important publications, including two outstanding papers accepted as the 2017 Canadian Urological Association prize essay winners. One of these is particularly timely: a contemporary Canadian cost analysis of blue light cystoscopy (BLC) with hexaminolevulinate (HAL) by Klaassen et al.1 The management of bladder cancer remains one of the most expensive of any malignancy, with a majority of those outlays due to ongoing surveillance and treatment for frequent recurrences. Despite some renewed enthusiasm in novel immunotherapeutics, such as the checkpoint inhibitors, it could be argued that BLC remains one of only a few substantive additions to our armamentarium for non-muscle-invasive bladder cancer (NMIBC) over the last decade