Economic implications of the modern treatment paradigm of glioblastoma: an analysis of global cost estimates and their utility for cost assessment

Abstract

Introduction: Glioblastoma is the most common primary brain tumor in adults. Standard of care includes maximal surgical resection of the tumor followed by concurrent chemotherapy and radiation. The treatment of glioblastoma must account for an increased disease severity and treatment intensity compared to other cancers which places a significant cost burden on the patient and health system. Cost assessments of glioblastoma treatment have been sparse in comparison to other solid cancer subtypes. This study evaluates all current available cost literature with an emphasis on the modern treatment paradigm to properly assess the economic implications of this disease.Methods: A critical review of 21 studies from 13 different countries measuring direct costs related to glioblastoma management was performed. Evaluated data included itemized costs, total costs of treatment regimens from diagnosis until death, the cost of second-line care after recurrence, and the incremental costs and cost-effectiveness of emerging therapies.Results: The average cost of a craniotomy was $10,042 across studies. Imaging for the duration of glioblastoma care had a mean cost of $2,788±3,719. Studies examined different combinations of treatment modalities. Utilization of the modern treatment paradigm led to a survival of 16.3 months across studies and had a mean cost of $62,602. Surgery for recurrent disease had an average cost of $27,442±18,992.Limitations and Conclusions: Direct cost estimates for glioblastoma varied substantially between institutions and countries and often failed to uniformly describe direct cost estimates associated with care for glioblastoma. The limitations of these studies make true economic assessment of standards of care, costs of recurrence, and incremental costs associated with adjunctive therapy uncertain.

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

“…Strategies to reduce cost may require different approaches depending on the type of procedure. 13,14 Therefore, we did not compare the costs of The mean cost of treating these patients was R$22,372 (US$4,166), which was lower than the cost calculated in other studies. Goel et al 14 calculated a mean cost of U $10,042 for craniotomy after analyzing 21 studies in 13 countries.…”

“…Strategies to reduce cost may require different approaches depending on the type of procedure. 13 14 Therefore, we did not compare the costs of microsurgery and endoscopy in the present evaluation – each procedure had several advantages. Providing a cheaper but effective treatment not only improves the economy, but also the QOL and OS for the patient.…”

Cost Matrix of Molecular Pathology in Glioma—Towards AI-Driven Rational Molecular Testing and Precision Care for the Future

“…In more recent studies, however, authors note the difficulties in carrying out cost analyses given the lack of QALY as the outcome measure and the prevalent use of overall survival or life years gained (LYG) [ 75 ], as well as the lack of quality of life values for specific health statuses or utilities [ 75 ]. A more recent study examining the cost of care in 13 countries in a global context confirms these limitations in determining the cost of care in glioma [ 81 ]. A retrospective claims database analysis from 2019 also notes this but provides more distinct numbers, reporting mean total per patient costs at 6 and 12 months of USD 117,325 and USD 162,550 for first-line treatment and USD 126,128 and USD 243,833 for the second line, with costs driven by the cost of RT and systemic cancer therapy [ 82 ].…”

Artificial intelligence in cancer imaging for diagnosis and evaluation of treatment response

“…Gliomas, the most common primary intracranial tumors, represent approximately 81% of primary malignant intracranial tumors [16,17]. Compared with other cancers, gliomas require a relatively high resource burden for diagnosis and management [18]. For the detection, diagnosis, classification and prognosis prediction of gliomas, magnetic resonance imaging (MRI) is the imaging method of choice [19].…”