Cost–effectiveness of temozolomide for the treatment of newly diagnosed glioblastoma multiforme

Abstract

Aim: To perform a systematic review on the costs and cost–effectiveness of concomitant and adjuvant temozolomide with radiotherapy for the treatment of newly diagnosed glioblastoma compared with initial radiotherapy alone. Methods: Electronic databases were searched for relevant publications on costs and cost–effectiveness until October 2008. Results: We found four relevant clinical trials, one cost study and two economic models. The mean survival benefit in the radiotherapy plus temozolomide group varied between 0.21 and 0.25 life-years. Treatment costs were between €27,365 and €39,092. The costs of temozolomide amounted to approximately 40% of the total treatment costs. The incremental cost–effectiveness ratios found in the literature were €37,361 per life-year gained and €42,912 per quality-adjusted life-year gained. However, the models are not comparable because different outcomes are used (i.e., life-years and quality-adjusted life-years). Conclusion: Although the models are not comparable according to outcome, the incremental cost–effectiveness ratios found are within acceptable ranges. We concluded that despite the high temozolomide acquisition costs, the costs per life-year gained and the costs per quality-adjusted life-year gained are comparable with other accepted first-line treatments with chemotherapy in patients with cancer.

Keywords::

• cost–effectiveness analyses
• economic evaluation
• glioblastoma multiforme
• radiotherapy
• temozolomide

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.