Cost-effectiveness of temozolomide for the treatment of newly diagnosed glioblastoma multiforme: a report from the EORTC 26981/22981 NCI-C CE3 Intergroup Study.

Details

Serval ID
serval:BIB_63954D1B9559
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cost-effectiveness of temozolomide for the treatment of newly diagnosed glioblastoma multiforme: a report from the EORTC 26981/22981 NCI-C CE3 Intergroup Study.
Journal
Cancer
Author(s)
Lamers L.M., Stupp R., van den Bent M.J., Al M.J., Gorlia T., Wasserfallen J.B., Mittmann N., Jin Seung S., Crott R., Uyl-de Groot C.A.
Working group(s)
EORTC 26981/22981 NCI-C CE3 Intergroup Study
Contributor(s)
Krauseneck P., Vecht CJ., Twijnstra A., Gijtenbeek J., Bogdahn U., van den Bent MJ. , Weller M., Kortmann RD., Taphoorn M., Grisold W., Fulton D., Gertler S., Perry J., Mason W., Curschmann J., Stupp R., Mirimanoff RO.
ISSN
0008-543X (Print)
ISSN-L
0008-543X
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
112
Number
6
Pages
1337-1344
Language
english
Notes
Publication types: Clinical Trial, Phase III ; Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: The study aimed to compare the cost-effectiveness of concomitant and adjuvant temozolomide (TMZ) for the treatment of newly diagnosed glioblastoma multiforme versus initial radiotherapy alone from a public health care perspective.
METHODS: The economic evaluation was performed alongside a randomized, multicenter, phase 3 trial. The primary endpoint of the trial was overall survival. Costs included all direct medical costs. Economic data were collected prospectively for a subgroup of 219 patients (38%). Unit costs for drugs, procedures, laboratory and imaging, radiotherapy, and hospital costs per day were collected from the official national reimbursement lists based on 2004. For the cost-effectiveness analysis, survival was expressed as 2.5 years restricted mean estimates. The incremental cost-effectiveness ratio (ICER) was constructed. Confidence intervals for the ICER were calculated using the Fieller method and bootstrapping.
RESULTS: The difference in 2.5 years restricted mean survival between the treatment arms was 0.25 life-years and the ICER was euro37,361 per life-year gained with a 95% confidence interval (CI) ranging from euro19,544 to euro123,616. The area between the survival curves of the treatment arms suggests an increase of the overall survival gain for a longer follow-up. An extrapolation of the overall survival per treatment arm and imputation of costs for the extrapolated survival showed a substantial reduction in ICER.
CONCLUSIONS: The ICER of euro37,361 per life-year gained is a conservative estimate. We concluded that despite the high TMZ acquisition costs, the costs per life-year gained are comparable to accepted first-line treatment with chemotherapy in patients with cancer.
Keywords
Adolescent, Adult, Aged, Antineoplastic Agents, Alkylating/economics, Antineoplastic Agents, Alkylating/therapeutic use, Brain Neoplasms/drug therapy, Brain Neoplasms/economics, Cost-Benefit Analysis, Dacarbazine/analogs & derivatives, Dacarbazine/economics, Disease-Free Survival, Follow-Up Studies, Glioblastoma/drug therapy, Glioblastoma/economics, Health Care Costs, Humans, Middle Aged, Quality-Adjusted Life Years, Survival Rate
Pubmed
Web of science
Create date
24/02/2009 15:45
Last modification date
20/08/2019 14:20
Usage data