PCN106 - The Economics of the Treatment and Follow-Up of Patients with Glioblastoma

Abstract

To summarize the existing literature regarding the medical cost associated with treatment and follow-up of glioblastoma. PubMed was used as search engine to retrieve publications in Medline using the search terms “(glioblastoma) AND (cost)” with a publication date filter (from January 1st 2000 up to September 1st2014) and language filter (English). This search yielded 107 publications of which 14 were relevant for this review. Costs were recalculated in Euros (€) using the June 5 2015 currency rate of $1 = €0.8914, CA$1 = €0.7131 and 1£ = €1.3667. Two studies calculated the average total medical cost of glioblastoma treatment including direct hospital centered costs from diagnosis to death and one study included healthcare payer perspective cost from diagnosis to two years of follow-up. The cost ranged between €12,229 - €43,894 (median: €39,000). Two studies calculated the average cost of the combination of surgery and chemoradiotherapy which varied from €16,007 per patient in Canada to €41,744 per patient in Switzerland. The addition of temozolomide to radiotherapy prolongs survival and improves quality of life. The incremental cost-effectiveness ratio (ICER) of temozolomide plus radiotherapy as compared to radiotherapy alone ranged from €49,054 (UK) to €77,854 (China) per quality adjusted life years (QALY) and €37,361 per life years gained (LYG)(Europe and Canada). One French study showed an improvement in survival of 4 months between 2004 and 2012, with an ICER of €54,355 per LYG, due to an increased use of temozolomide and bevacizumab. The literature on the cost of treatment and follow up of glioblastoma patients and on the cost-effectiveness of treatment modalities used in glioblastoma is scarce. Wide variations in cost are reported, probably reflecting the variation in health care systems.