Current State of Health Economic Analyses for Low-Grade Glioma Management: A Systematic Review

Tuohy, Kyle; Fernandez, Ajay; Hamidi, Nima; Padmanaban, Varun; Mansouri, Alireza

doi:10.1016/j.wneu.2021.05.112

Cited by 4 publications

(6 citation statements)

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“…Several studies have previously calculated the specific costs of low-grade gliomas and GBM; however, they included adjuvant therapy in the total cost, which was not performed on the patients included in the present study. [37][38][39][40] In the USA, a patient remains in one center for the entire treatment, which allows a better evaluation of the data. 40 Unfortunately, in Brazil, patients need to perform each part of their treatment in one sector; hence, the records are not uniform.…”

Section: Discussionmentioning

confidence: 99%

“…Even in a population of stable, high-functioning patients, financial burden and workforce morbidity was ubiquitous across all tumor subtypes, treatment paradigms, and income levels. 39,40 Patients also had an increased risk of anxiety, depression, and neurocognitive deficits. 39,41 Implementing digital referrals to a multidisciplinary neuro-oncological triage panel may help reduce costs.…”

Section: Discussionmentioning

confidence: 99%

“…39,40 Patients also had an increased risk of anxiety, depression, and neurocognitive deficits. 39,41 Implementing digital referrals to a multidisciplinary neuro-oncological triage panel may help reduce costs. This approach is feasible and would facilitate swift referrals that are tailored for the patients at costs and time investment that are comparable to standard referrals.…”

Section: Discussionmentioning

confidence: 99%

“…39 40 Patients also had an increased risk of anxiety, depression, and neurocognitive deficits. 39 41…”

Section: Discussionmentioning

confidence: 99%

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An economic study of neuro-oncological patients in a large developing country: a cost analysis

et al. 2022

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Background Neuro-oncological patients require specialized medical care. However, the data on the costs incurred for such specialized care in developing countries are currently lacking. These data are relevant for international cooperation. Objective The present study aimed to estimate the direct cost of specialized care for an adult neuro-oncological patient with meningioma or glioma during hospitalization in the largest philanthropic hospital in Latin America. Methods The present observational economic analysis describes the direct cost of care of neuro-oncological patients in Santa Casa de São Paulo, Brazil. Only adult patients with a common primary brain tumor were included. Results Due to differences in the system records, the period analyzed for cost estimation was between December 2016 and December 2019. A group of patients with meningiomas and gliomas was analyzed. The estimated mean cost of neurosurgical hospitalization was US$4,166. The cost of the operating room and intensive care unit represented the largest proportion of the total cost. A total of 17.5% of patients had some type of infection, and 66.67% of these occurred in nonelective procedures. The mortality rate was 12.7% and 92.3% of all deaths occurred in emergency procedures. Conclusions Emergency surgeries were associated with an increased rate of infections and mortality. The findings of the present study could be used by policymakers for resource allocation and to perform economic analyses to establish the value of neurosurgery in achieving global health goals.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…39 40 Patients also had an increased risk of anxiety, depression, and neurocognitive deficits. 39 41…”

Section: Discussionmentioning

confidence: 99%

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An economic study of neuro-oncological patients in a large developing country: a cost analysis

et al. 2022

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“…There is a scarcity of research regarding cost-effectiveness for DLGG management (32). Due to the relatively low prevalence of DLGG and their heterogeneity, prospective studies may prove challenging.…”

Section: Limitations and Future Perspectivesmentioning

confidence: 99%

Early costs and complications of first-line low-grade glioma treatment using a large national database: Limitations and future perspectives

Tuohy

Ba²,

Bhanja³

et al. 2023

Front. Surg.

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IntroductionDiffuse Low-grade gliomas (DLGG, WHO Grade II) are a heterogenous group of tumors comprising 13–16% of glial tumors. While maximal safe resection is endorsed as the best approach to DLGG, compared to more conservative interventions like stereotactic biopsy, the added costs and risks have not been systematically evaluated. The purpose of this study was to better understand the complication rates and costs associated with each intervention.MethodsA retrospective cohort study using data from the IBM Watson Health MarketScan® Commercial Claims and Encounters database was conducted, using the International Classification of Diseases, Ninth Revision (ICD-9) codes corresponding to DLGG (2005–2014). Current Procedure Terminology, 4th Edition (CPT-4) codes were used to differentiate resection and biopsy cohorts. Inverse weighting by the propensity score was used to balance baseline potential confounders (age, sex, pre-op seizure, geographic region, year, Charleston Comorbidity Index). Complication rates, hospital mortality, readmission, and costs were compared between groups.ResultsWe identified 5,784 and 3,635 patients undergoing resection and biopsy, respectively, for initial DLGG management. Resection was associated with greater 30-day complications (29.17% vs. 26.34%; p < 0.05). However, this association became non-significant after inverse propensity weighting (adjusted odds ratio = 1.09; 0.98–1.20). There was no statistically significant difference in unadjusted, 30-day hospital mortality (p = 0.06) or re-admission (p = 0.52). Resection was associated with higher 90-day total costs (p < 0.0001) and drug costs (p < 0.0001). Biopsy was associated with greater index procedure costs (p < 0.0001). Long-term outcomes and evaluation of DLGG subtypes was not possible given limitations in the metrics recorded in MarketScan and lack of specificity in the ICD coding system.ConclusionResection was not associated with an increase in the adjusted complication rate after balancing for baseline prognostic factors. Total costs and drug costs were higher with resection of DLGG, but the index procedure costs were higher for biopsy. This data should help to facilitate prospective health economic analyses in the future to understand the cost-effectiveness, and impact on quality of life, for DLGG interventions. However, the use of large national databases for studying long-term outcomes in DLGG management should be discouraged until there is greater specificity in the ICD coding system for DLGG subtypes.

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A perioperative study of Safusidenib in patients with IDH1 -mutated glioma

Cain,

Topp,

Rosenthal

et al. 2024

Future Oncology

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This is a single arm, open label perioperative trial to assess the feasibility, pharmacokinetics and pharmacodynamics of treatment with safusidenib following biopsy, and prior to surgical resection in patients with IDH1 mutated glioma who have not received radiation therapy or chemotherapy. Fifteen participants will receive treatment in two parts. First, biopsy followed by one cycle (28 days) of safusidenib, an orally available, small molecular inhibitor of mutated IDH1, then maximal safe resection of the tumor (Part A). Second, after recovery from surgery, safusidenib until disease progression or unacceptable toxicity (Part B). This research will enable objective measurement of biological activity of safusidenib in patients with IDH1 mutated glioma. Anti-tumor activity will be assessed by progression free survival and time to next intervention. Clinical Trial Registration: NCT05577416 ( ClinicalTrials.gov )

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Current State of Health Economic Analyses for Low-Grade Glioma Management: A Systematic Review

Cited by 4 publications

References 50 publications

An economic study of neuro-oncological patients in a large developing country: a cost analysis

An economic study of neuro-oncological patients in a large developing country: a cost analysis

Early costs and complications of first-line low-grade glioma treatment using a large national database: Limitations and future perspectives

A perioperative study of Safusidenib in patients with IDH1 -mutated glioma

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