Cost-effectiveness of temozolomide for the treatment of newly diagnosed glioblastoma multiforme.
OBJECTIVE
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 euros and 39,092 euros. 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 euros per life-year gained and 42,912 euros 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).


CONCLUSIONS
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.
Uyl-de Groot
Carin A
CA
Institute for Medical Technology Assessment/Department of Health Policy and Management, Erasmus University Medical Center, PO Box 1738, 3000 DR Rotterdam, The Netherlands. c.uyl@erasmusmc.nl
Stupp
Roger
R
van der Bent
Martin
M
D018906:Antineoplastic Agents, Alkylating / Q000191:economics* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D016527:Drug Costs; D005909:Glioblastoma / Q000191:economics* / Q000401:mortality / Q000628:therapy; D006801:Humans; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D016019:Survival Analysis; D000077204:Temozolomide; D016896:Treatment Outcome
D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide