title: Indirect costs associated with glioblastoma: Experience at one hospital.
abstract: BACKGROUND
  Glioblastoma is the most common primary brain tumour. Despite advances in treatment, its prognosis remains dismal, with a mean survival time of about 14 months. Many articles have addressed direct costs, those associated with the diagnosis and treatment of the disease. Indirect costs, those associated with loss of productivity due to the disease, have seldom been described.
  
  
  METHODS
  We conducted a retrospective study in patients diagnosed with glioblastoma at Hospital Universitario Donostia between January 1, 2010 and December 31, 2013. We collected demographics, data regarding the treatment received, and survival times. We calculated the indirect costs with the human capital approach, adjusting the mean salaries of comparable individuals by sex and age and obtaining mortality data for the general population from the Spanish National Statistics Institute. Past salaries were updated to 2015 euros according to the annual inflation rate and we applied a discount of 3.5% compounded yearly to future salaries.
  
  
  RESULTS
  We reviewed the records of 99 patients: 46 women (mean age 63.53) and 53 men (mean age 59.94); 29 patients underwent a biopsy and the remaining 70 underwent excisional surgery. Mean survival was 18.092 months for the whole series. The total indirect cost for the series was €11 080 762 (2015). Mean indirect cost per patient was €111 926 (2015).
  
  
  CONCLUSIONS
  Although glioblastoma is a relatively uncommon type of tumour, accounting for only 4% of all cancers, its poor prognosis and potential sequelae generate disproportionately large morbidity and mortality rates which translate to high indirect costs. Clinicians should be aware of the societal impact of glioblastoma and indirect costs should be taken into account when cost effectiveness studies are performed to better illustrate the overall consequences of this disease.
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España. Electronic address: joseundabeitia@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Undabeitia
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España.
authors.forename: S
authors.initials: S
authors.lastname: Torres-Bayona
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España.
authors.forename: N
authors.initials: N
authors.lastname: Samprón
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Departamento de Cirugía y Radiología y Medicina Física, Universidad del País Vasco, Donostia, España.
authors.forename: M
authors.initials: M
authors.lastname: Arrázola
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España.
authors.forename: A
authors.initials: A
authors.lastname: Bollar
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España.
authors.forename: M
authors.initials: M
authors.lastname: Armendariz
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España.
authors.forename: P
authors.initials: P
authors.lastname: Torres
authors.affiliation: Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Anatomía Patológica, Hospital Universitario Donostia, Donostia, España.
authors.forename: I
authors.initials: I
authors.lastname: Ruiz
authors.affiliation: Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Anatomía Patológica, Hospital Universitario Donostia, Donostia, España.
authors.forename: M C
authors.initials: MC
authors.lastname: Caballero
authors.affiliation: Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Oncología Médica, Hospital Universitario Donostia, Donostia, España.
authors.forename: L
authors.initials: L
authors.lastname: Egaña
authors.affiliation: Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Oncología Radioterápica, Hospital Universitario Donostia, Donostia, España.
authors.forename: A
authors.initials: A
authors.lastname: Querejeta
authors.affiliation: Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Neurorradiología, Osatek, Hospital Universitario Donostia, Donostia, España.
authors.forename: J
authors.initials: J
authors.lastname: Villanua
authors.affiliation: Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Radiología, Hospital Universitario Donostia, Donostia, España.
authors.forename: E
authors.initials: E
authors.lastname: Pardo
authors.affiliation: Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Radiología, Hospital Universitario Donostia, Donostia, España.
authors.forename: I
authors.initials: I
authors.lastname: Etxegoien
authors.affiliation: Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Farmacología, Hospital Universitario Donostia, Donostia, España.
authors.forename: G
authors.initials: G
authors.lastname: Liceaga
authors.affiliation: Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Neurología, Hospital Universitario Donostia, Donostia, España.
authors.forename: M
authors.initials: M
authors.lastname: Urtasun
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Donostia, Donostia, España.
authors.forename: M
authors.initials: M
authors.lastname: Michan
authors.affiliation: Servicio de Epidemiología Clínica, Hospital Universitario Donostia, Donostia, España.
authors.forename: J I
authors.initials: JI
authors.lastname: Emparanza
authors.affiliation: Grupo de Neuro-oncología, Instituto de Investigación Sanitaria Biodonostia, Donostia, España.
authors.forename: P
authors.initials: P
authors.lastname: Aldaz
authors.affiliation: Grupo de Neuro-oncología, Instituto de Investigación Sanitaria Biodonostia, Donostia, España.
authors.forename: A
authors.initials: A
authors.lastname: Matheu
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Departamento de Cirugía y Radiología y Medicina Física, Universidad del País Vasco, Donostia, España.
authors.forename: E
authors.initials: E
authors.lastname: Úrculo
mesh_terms: D001932:Brain Neoplasms / Q000191:economics; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000601:surgery*; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Chemotherapy; Costes; Costs; Glioblastoma; Prognosis; Pronóstico; Quimioterapia; Radioterapia; Radiotherapy; Supervivencia; Survival