gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Quality-adjusted life years in Glioma patients – a systematic review on currently available data and the lack of evidence-based utilities

Qualitäts-adjustierte Lebensjahre in Gliom-Patienten – aktuelle Datenlage und das Fehlen gesundheitsspezifischer Nutzwerte

Meeting Abstract

  • presenting/speaker Vicki Butenschön - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Anna Kelm - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Sandro Krieg - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP181

doi: 10.3205/19dgnc517, urn:nbn:de:0183-19dgnc5179

Published: May 8, 2019

© 2019 Butenschön et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Cost-effectiveness studies gain importance in the context of rising health care expenses and treatment options. Especially in the neurooncological context, surgical therapy may increase overall survival, but restrain the patient by postoperative disabilities. Quality of life years (QALYs) express treatment effects and are based on health utilities (quantitative values to describe the current disability ranging from 0: worst to 1: perfect health). In our study, we analyze the current evidence on health economic evaluations in glioma patients.

Methods: Based on the key words “glioma and QALY”, we performed a systematic database search including Pubmed and Cochrane library. Studies were critically appraised for statistical analyzes including glioma patients, health economic modeling and detailed health outcome. Study evidence was classified according to levels of evidence for therapeutic studies from the Centre for Evidence-Based Medicine (Oxford).

Results: 33 studies (1997 to 2018) were identified, 26 matched our inclusion criteria. Studies addressed surgical cost-efficiency and/or the standard treatment (n=10/n=5), postoperative chemotherapy (n=6) and 5-ALA (n=3). Only 16 studies used QALY as the outcome measure, most used overall survival or life years gained (LYG). Utilities were either based on one single study (Garside et al. 2007) or derived from VAS scale. None assessed quality of life values for specific health statuses or utilities. Incremental cost-effectiveness ratios varied from 9097€/QALY (5-ALA) to $607,966/QALY (Avastin).

Conclusion: Only one study generated utility values to conduct cost-effectiveness analyzes (CEA), most studies used indirect outcomes such as LYG or based their model on previously published data. Health economic evaluations lack specific utilities, further investigations are necessary to conduct reliable CEA in the neurosurgical context.