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Treatment Costs for Glioblastoma Multiforme in Nova Scotia

Published online by Cambridge University Press:  02 March 2017

Ivar Mendez ,
Philip Jacobs ,
Andrea MacDougall  and
Margarita Schultz
Ivar Mendez*
Affiliation:
Department of Surgery, Division of Neurosurgery, Queen Elizabeth II Health Sciences Centre, and Dalhousie University, Halifax, Nova Scotia, Canada
Philip Jacobs
Affiliation:
Department of Public Health Sciences, University of Alberta and Health Institute of Health Economics, Edmonton, Alberta, Canada
Andrea MacDougall
Affiliation:
Department of Surgery, Division of Neurosurgery, Queen Elizabeth II Health Sciences Centre, and Dalhousie University, Halifax, Nova Scotia, Canada
Margarita Schultz
Affiliation:
Pharm Access, Inc, Montreal, Quebec, Canada
*
Queen Elizabeth II Health Sciences Centre, Halifax Infirmary, 1796 Summer Street, Room #3806, Halifax, Nova Scotia, Canada B3H 3A7
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Abstract:

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Background:

Glioblastoma Multiforme (GBM) is the most common and malignant brain tumor in adults. The median survival in patients harboring this neoplasm is 12 months irrespective of any form of therapy. Health care costs of illnesses with high mortality rates, such as GBM, are of particular interest in times of constrained health care resources. No information regarding costs for the treatment of patients with GBM is available in Canada. The aim of this study was to conduct an analysis of the costs of treatment of GBM in Nova Scotia.

Methods:

Patients with histologically proven GBM during a three year period (1996-1998) in Nova Scotia were included in the study. Analysis was based on hospital costs supplemented by data on additional medical services received following discharge for the primary intervention.

Results:

The mean cost of medical care per patient from the time of diagnosis to death was $ 17,149. The highest costs were related to hospitalization with ward costs alone accounting for 48% of all costs. Radiotherapy costs were 25%, surgery costs were 16% and chemotherapy costs were 7% of all costs. Costs for diagnostic procedures were 6% of the total costs.

Conclusion:

Our data reflect the costs and practice pattern in the treatment of GBM in Nova Scotia and may be of value as an initial attempt to analyze costs of treatment of GBM in Canada.

Résumé:

RÉSUMÉ:Introduction:

Le glioblastome multiforme (GBM) est la tumeur cérébrale la plus fréquente et la plus maligne chez les adultes. La survie médiane chez les patients porteurs de cette tumeur est de 12 mois, quel que soit le mode de traitement. Les coûts du traitement de maladies ayant un taux élevé de mortalité comme le GBM ont un intérêt particulier en période de contraintes budgétaires dans le domaine de la santé. Il n'existe pas d'information sur les coûts du traitement des patients atteints de GBM au Canada. Le but de cette étude était d'effectuer une analyse des coûts du traitement du GBM en Nouvelle-Écosse.

Méthodes:

Les patients ayant un GBM prouvé par anatomopathologie pendant une période de trois ans (1996-1998) en Nouvelle-Écosse sont inclus dans l'étude. L'analyse était basée sur les coûts hospitaliers et les coûts extrahospitaliers à la suite de l'intervention initiale.

Résultats:

Le coût moyen des soins médicaux par patient à partir du moment du diagnostic jusqu'au décès était de $17,149. Les frais les plus élevés étaient attribuables à l'hospitalisation, les frais d'hébergement étant responsables de 48% de tous les coûts. Les coûts de la radiothérapie constituaient 25% du total, la chirurgie 16% et la chimiothérapie 7%. Les coûts reliés à la démarche diagnostique étaient de 6% du total.

Conclusion:

Nos données reflètent les coûts et le profil de pratique concernant le traitement du GBM en Nouvelle-Écosse et pourraient être utiles comme étape initiale d'une analyse des coûts de traitement du GBM au Canada.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 28 , Issue 1 , February 2001 , pp. 61 - 65
Copyright
Copyright © The Canadian Journal of Neurological 2001

References

REFERENCES

1. National Cancer Institute of Canada. Canadian Cancer Statistics 1999. Toronto, Canada, 1999.Google Scholar
2. Williams, B, Dewar, R, Kirby, S, Mendez, I. The geographic distribution of glioblastoma multiforme in Nova Scotia. Can J Neurol Sci 1998; 25(Suppl. 1):S69.Google Scholar
3. Mehta, V, Mendez, I. Intracranial astrocytomas: concepts and therapy. Can J Diagnosis 1999; 9:126–136.Google Scholar
4. Scott, JN, Rewcastle, NB, Brasher, MA, et al. Which glioblastoma multiforme patient will become a long- term survivor? A population- based study. Ann Neurol 1999; 46:183–187.Google Scholar
5. Silverstein, MD, Terrance, CL, Harmsen, WS. High grade astrocytomas: resource use, clinical outcomes, and cost of care. Mayo Clin Proc 1996; 71:936–944.CrossRefGoogle ScholarPubMed
6. Rutigliano, MJ, Lunsford, LD, Kondziolka, D. The cost effectiveness of stereotactic radiosurgery versus surgical resection in the treatment of solitary metastatic brain tumors. Neurosurgery 1995; 37:445–455.Google Scholar
7. Penar, PL, Wilson, JT. Cost and survival analysis of metastatic cerebral tumors treated by resection and radiation. Neurosurgery 1994; 34:888–894.Google Scholar
8. Konski, A, Bracey, P, Weiss, S, et al. Cost-utility analysis of a malignant glioma protocol. Int J Radiat Oncol Biol Phys 1997; 39:575–578.CrossRefGoogle ScholarPubMed
9. Latif, ZF, Signorini, D, Gregor, A, et al. The cost of managing patients with malignant glioma at a neuro- oncology clinic. Br J Neurosurgery 1997; 12:118–122.CrossRefGoogle Scholar
10. Mehta, M, Noyes, W, Craig, B, et al. A cost-effectiveness and cost-utility analysis of radiosurgery vs. resection for single brain metastases. Int J Radiat Oncol Biol Phys 1997; 39:445–454.CrossRefGoogle ScholarPubMed
11. Scitovsky, AA, Carpon, AM. Medical care at the end of life: the interaction of economics and ethics. Ann Rev Public Health 1986; 7:59–75.CrossRefGoogle Scholar
12. Lubitz, JD, Riley, GF. Trends in medicare payments in the last year of life. N Eng J Med 1993; 328:1092–1096.Google Scholar
13. Hartunian, NS, Smart, CN, Thompson, MS. The incidence and economic costs of cancer, motor vehicle injuries, coronary heart disease, and stroke: a comparative analysis. Am J Public Health 1980; 70:1249–1260.Google Scholar
14. Simpson, JR, Horton, J, Scott, C, et al. Influence of location and extent of surgical resection on survival of patients with glioblastoma multiforme: results of three consecutive radiation therapy oncology group (RTOG) clinical trials. Int J Radiat Oncol Biol Phys 1993; 26:239–244.CrossRefGoogle ScholarPubMed
15. Leibel, SA, Scott, CB, Loeffler, JS. Contemporary approaches to the treatment of malignant gliomas with radiation treatment. Sem Oncol 1994; 21:198–219.Google Scholar
16. Whittle, IR. Management of primary malignant brain tumor. J Neurol Neurosurg Psychiatry 1996; 60:2–5.Google Scholar
17. Fine, HA. The basis for current treatment recommendations for malignant gliomas. J Neurooncol 1994; 20:11–20.CrossRefGoogle ScholarPubMed
18. Walker, MD, Alexander, E Jr. Hunt, WE, et al. Evaluation of BCNU and /or radiotherapy in the treatment of anaplastic gliomas: a cooperative clinical trial. J Neurosurg 1978; 49:333–343.Google Scholar
19. Berthelot, JM, Will, BP, Evans, WK, et al. Decision framework for chemotherapeutic interventions for metastatic non-small-cell lung cancer. J Natl Cancer Inst 2000; 92:1321–1329.CrossRefGoogle ScholarPubMed
20. Brem, H, Piantadosi, S, Burger, PC, et al. Placebo- controlled trail of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. Lancet 1995; 345:1008–1012.Google Scholar
21. Valtonen, S, Timonen, U, Toivanen, P, et al. Interstitial Chemotherapy with Carmustine-loaded polymers for high-grade gliomas: a randomized double-blind study. Neurosurgery 1997; 41:44–49.Google Scholar