PEB - Pacific Edge Ltd

[Roskat]

CxBladder test kits available on line in NZ at $368

[thegreatestben]

DD speaking to sharesies today
https://www.youtube.com/watch?v=PDvlEGHr9BQ

[kiora]

CxBladder test kits available on line in NZ at $368

I thought they where charging around $900/test a few years ago?

[Greekwatchdog]

Not in NZ. The US Market is where they get that and then some..

[Lescy]

I'm a hospital clinical staff member & hope this answers part of your question.
I just checked our DHB guidelines and CxBladderTriage is firmly entrenched in the workup procedure for both patients currently in hospital, and those who are at home. I see patients referred for CxBladder during my routine work.

At my DHB, the CxBladder test is used as a screening test for patients with haematuria (blood in the urine) that isn't explained by a bladder infection. Some higher risk patients also have an ultrasound at this point. Our guidelines highlight that it picks up 97% of urological cancers, and will 'rule out' 99% of patients who don't have bladder cancer. If a positive result is reported, the patient is then referred to the urologist. This is when further specialist investigations such as imaging may be undertaken, to both finalise a diagnosis and decide upon a treatment plan.

(replying to psychic from 7/8/21)

[Retired Doc]

Thank you, I'm not sure and had hoped you might comment. I was questioning PE's suggestion that people in the far North could take the Triage Test without travelling to main centres when Triage needs the support of imaging anyway. (this was the DHB's finding in the orig study)
What were your thoughts on this?

Thanks Psychic.
The excellent negative predictive value and it’s apparent 100% ( though I am always wary of any thing said to be 100% in medicine) detection of nasty tumours will hugely reduce the uncertainty in managing haematuria in the primary care setting at least. If you receive a negative result then you can watch and repeat later knowing in the very small chance of a tumour being missed at least it won’t be at the nasty end of the spectrum. This will take pressure ( probably quite a lot ) off imaging and, Hallelujah for the patients, cut down cystoscopy numbers significantly with an attendant saving in resources. Win win win all around. Haematuria ( particularly microscopic) was often the source of significant clinical management anxiety for me in primary care and I believe my colleagues and this testing process will leave a clearer path in many cases which would otherwise have carried a significant burden of uncertainty for the clinician and patients as will as inconvenience and discomfort for the latter

[psychic]

Lescy and Retired Doc, thank you both for these excellent posts.

[Retired Doc]

Thank you Psychic.You are welcome. I think it is important to refresh views as new information becomes available even if it only confirms previous positions. This most recent study is another plank in a very sound base. IMHO CxBladder will be a fundamental part of any haematuria work up algorithm.

[Arthur]

Thank you Psychic.You are welcome. I think it is important to refresh views as new information becomes available even if it only confirms previous positions. This most recent study is another plank in a very sound base. IMHO CxBladder will be a fundamental part of any haematuria work up algorithm.

Any idea why the take-up rate is so slow in USA? I would off thought even the most mercenary urologist in USA would have seen the merit of clipping the ticket during lock-down by getting "clients" to take the test, they must have had a database of suitable candidates to draw on.
Ethical urologists would have sent them to do the best by their patients.
What am I missing?

[Retired Doc]

Any idea why the take-up rate is so slow in USA? I would off thought even the most mercenary urologist in USA would have seen the merit of clipping the ticket during lock-down by getting "clients" to take the test, they must have had a database of suitable candidates to draw on.
Ethical urologists would have sent them to do the best by their patients.
What am I missing?

My 2c take is that CxBladder is a major disruptor and the AUA is likely a very conservative organisation. Also as you are likely aware the US health system bears a heavy litigation burden and there will be some anxiety re omitting an erstwhile gold standard procedure (cystoscopy) where you actually “have a look” and using a molecular test. What will likely weigh against persisting with cystoscopy is patient preference and the fact that there is a complication rate and morbidity with cystoscopy which although very low does raise the spectre of a lawyer asking in the situation of a cystoscopy gone wrong, why cystoscopy was done when a simple urine test would have sufficed.
I am not sure how the money flows in the US but cutting down on cystoscopies is going to decrease revenue for some urologists and hospitals/ clinics. Insurance companies should love CxB but again I donÂ’t know the details of the system.
I believe CxB is now popular in NZ urology practice and it wonÂ’t be far off penetrating primary care here albeit with some restrictions.
I feel confident that my modest PEB holding will grow but being largely ignorant of the economics of this I have no idea of by what factor the increasing numbers of tests will translate into profits. There will be others out there who may be able to comment on thatÂ…Â…Â…