Cost-effectiveness of 5-aminolevulinic acid-induced fluorescence in malignant glioma surgery.
OBJECTIVE
This study evaluates the cost-effectiveness of 5-aminolevulinic acid (5-ALA, Gliolan®) in patients undergoing surgery for malignant glioma, in standard clinical practice conditions in Spain.


METHODS
Cost-effectiveness ratios were determined in terms of incremental cost per complete resection (CR) and incremental cost per additional quality-adjusted life year (QALY), based on data collected in the VISIONA observational study.


RESULTS
Incremental cost with 5-ALA versus conventional surgery using white light only amounts to € 4550 per additional CR achieved and € 9021 per QALY gained. A sensitivity analysis shows these results to be robust.


CONCLUSIONS
Malignant glioma surgery guided by 5-ALA fluorescence entails a moderate increase in hospital costs compared to current surgical practice and can be considered a cost-effective innovation.
Universidad Autónoma de Barcelona, Bellaterra, Cerdanyola del Vallès, España. Electronic address: ericjohn.slof@uab.cat.
J
J
Slof
Departamento de Neurocirugía, Clínica Universidad de Navarra, Pamplona, España.
R
R
Díez Valle
Laboratorios Gebro Pharma S.A., Barcelona, España.
J
J
Galván
D000328:Adult; D000368:Aged; D000622:Aminolevulinic Acid / Q000191:economics*; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005453:Fluorescence; D005910:Glioma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000191:economics; D019057:Quality-Adjusted Life Years; D013030:Spain
D000622:Aminolevulinic Acid
5-aminolevulinic acid; Cirugía guiada con fluorescencia; Cost-effectiveness; Coste-efectividad; Fluorescence-guided surgery; Glioblastoma; Glioma maligno; Malignant glioma; Ácido 5-aminolevulínico