Pharmacoeconomic Analysis of Intravenous Temozolomide for the Treatment of Newly Diagnosed Glioblastoma Multiforme in Russia

To perform comparative pharmacoeconomic analysis of concomitant, adjuvant and second-line intravenous temozolomide (ITMZ) for the treatment of newly diagnosed glioblastoma multiforme versus initial radiotherapy and second-line therapy with ITMZ. Analysis of the published clinical trials was conducted to evaluate comparative efficacy and safety of the studied therapy options. Direct medical costs included drug therapy and hospital treatment. All prices were for Moscow region, year 2013. Expected difference in direct medical costs was calculated in Excel based model. For the cost-effectiveness analysis, survival was expressed as 2.5 years restricted mean estimates from EORTC-NCIC study. The incremental cost-effectiveness ratio (ICER) was estimated. One-way sensitivity analysis was made. According to published trials the treatment of newly diagnosed glioblastoma multiforme with ITMZ was associated with a significant improvement in overall survival. The difference in 2.5 years restricted mean survival between the treatment arms was 0.25 life-years and the ICER was 76,982.6 USD per life-year. The one-way sensitivity analysis showed that the results are more sensitive to the variations of key model parameter, such as price of ITMZ. The concomitant, adjuvant and second-line ITMZ was more effective and economically justified treatment option for patients with newly diagnosed glioblastoma multiforme.