A microcosting study of microsurgery, LINAC radiosurgery, and gamma knife radiosurgery in meningioma patients.
The aim of the present study is to determine and compare initial treatment costs of microsurgery, linear accelerator (LINAC) radiosurgery, and gamma knife radiosurgery in meningioma patients. Additionally, the follow-up costs in the first year after initial treatment were assessed. Cost analyses were performed at two neurosurgical departments in The Netherlands from the healthcare providers' perspective. A total of 59 patients were included, of whom 18 underwent microsurgery, 15 underwent LINAC radiosurgery, and 26 underwent gamma knife radiosurgery. A standardized microcosting methodology was employed to ensure that the identified cost differences would reflect only actual cost differences. Initial treatment costs, using equipment costs per fraction, were <euro>12,288 for microsurgery, <euro>1,547 for LINAC radiosurgery, and <euro>2,412 for gamma knife radiosurgery. Higher initial treatment costs for microsurgery were predominantly due to inpatient stay (<euro>5,321) and indirect costs (<euro>4,350). LINAC and gamma knife radiosurgery were equally expensive when equipment was valued per treatment (<euro>2,198 and <euro>2,412, respectively). Follow-up costs were slightly, but not significantly, higher for microsurgery compared with LINAC and gamma knife radiosurgery. Even though initial treatment costs were over five times higher for microsurgery compared with both radiosurgical treatments, our study gives indications that the relative cost difference may decrease when follow-up costs occurring during the first year after initial treatment are incorporated. This reinforces the need to consider follow-up costs after initial treatment when examining the relative costs of alternative treatments.
Tan
Siok Swan
SS
Erasmus Universiteit Rotterdam, Institute for Medical Technology Assessment, PO Box 1738, 3000 DR Rotterdam, The Netherlands. tan@bmg.eur.nl
van Putten
Erik
E
Nijdam
Wideke M
WM
Hanssens
Patrick
P
Beute
Guus N
GN
Nowak
Peter J
PJ
Dirven
Clemens M
CM
Hakkaart-van Roijen
Leona
L
D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000191:economics* / Q000601:surgery; D008579:Meningioma / Q000191:economics* / Q000601:surgery; D008866:Microsurgery / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D010315:Particle Accelerators / Q000191:economics*; D016634:Radiosurgery / Q000191:economics* / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome