© 2005 by the Society forNeuro-Oncology
Cost of temozolomide therapy and global care for recurrent malignantgliomas followed until death
Health Technology Assessment Unit (J.B.W.), Multidisciplinary Oncology Centre (S.O., S.L., R.S.),Centre Hospitalier Universitaire Vaudois, University of Lausanne, CH-1011Lausanne, Switzerland
1 Address correspondence to Jean-Blaise Wasserfallen, University Hospital(CHUV), Rue du Bugnon, 46, CH-1011 Lausanne, Switzerland(Jean-Blaise.Wasserfallen{at}chuv.hospvd.ch).
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Abstract |
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Effectiveness and costs of care and treatment of recurrent malignantgliomas are largely unknown. In this study, 49 patients (32 males, 17 females;mean age, 49; age range, 23-79) were treated with temozolomide (TMZ) forrecurrent or progressive malignant gliomas after standard radiation therapy.Cost assessment (payer's perspective) singled out treatment for firstrecurrence and all costs of care until death. We computed personnel costs aswages; drugs, imaging, and laboratory tests as prices; and hospitalizations asday rates. Patients were administered a median of five TMZ cycles atrecurrence. Drug acquisition costs amounted to 
2206 per cycle (76% oftotal costs). Seven patients showed no second recurrence (two are stillalive), 16 received no further chemotherapy and died after 3.9 months, and 26received second-line chemotherapy. After the second progression, mediansurvival was 4.0 months (95% confidence interval, 1.8-6.1). Overall monthlycosts of care varied between 2450 and 3242 among the differentgroups, and median cost-effectiveness and cost utility ranged from28,817 to 38,450 and from 41,167 to 53,369 per life ofyear and per quality-adjusted life-year gained, respectively. We conclude thatdespite high TMZ drug acquisition costs, care of recurrent malignant gliomasis comparable to other accepted therapies.
Received July 8, 2004; Accepted December 13, 2004