A microcosting study of microsurgery, LINAC radiosurgery, and gamma knife radiosurgery in meningioma patients

Tan, Siok Swan; Putten, Erik H.P. van; Nijdam, Wideke; Hanssens, Patrick; Beute, Guus; Nowak, Peter; Dirven, Clemens M.F.; Roijen, Leona Hakkaart-van

doi:10.1007/s11060-010-0243-4

Cited by 8 publications

(6 citation statements)

References 23 publications

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“…Several studies have reported the costs of different treatment modalities (e.g., surgery and sterotactical radiosurgery) for meningioma patients [6][7][8]. However, to date, no studies have described healthcare utilization and its related costs among meningioma patients on the long-term.…”

Section: Introductionmentioning

confidence: 99%

Healthcare utilization and costs among intracranial meningioma patients during long-term follow-up

et al. 2023

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Purpose Few studies have reported on healthcare utilization and costs for intracranial meningioma patients, while the tumor and its treatment profoundly affect patients’ functioning and well-being. Here we evaluated healthcare utilization and costs, including their determinants. Methods A multicenter cross-sectional study of adult meningioma patients ≥ 5 years after intervention. Patients completed three validated patient-reported outcome measures (PROMs) assessing patients ‘functioning and wellbeing (SF-36, EORTC QLQ-BN20, and HADS) and a study-specific questionnaire assessing healthcare utilization over the previous twelve months. Healthcare costs of the twelve months prior were calculated using reported healthcare utilization ≥ 5 years after intervention by the Dutch Manual for Economic Evaluation in Healthcare. Determinants for healthcare utilization and costs were determined with regression analyses. Results We included 190 patients with WHO grade I or II meningioma after a mean follow-up since intervention of 9.2 years (SD 4.0). The general practitioner (80.5%), physiotherapist (37.9%), and neurologist (25.4%) were visited most often by patients. Median annual healthcare costs were €871 (IQR €262–€1933). Main contributors to these costs were medication (45.8% of total costs, of which anti-seizure medication was utilized most [21.6%]), specialist care (17.7%), and physiotherapy (15.5%). Lower HRQoL was a significant determinant for higher healthcare utilization and costs. Conclusion In patients with meningioma, medication costs constituted the largest expenditure of total healthcare costs, in particular anti-seizure medication. Particularly a lower HRQoL was a determinant for healthcare utilization and costs. A patient-specific approach aimed at improving patients’ HRQoL and needs could be beneficial in reducing disease burden and functional recovery.

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Section: Introductionmentioning

confidence: 99%

Healthcare utilization and costs among intracranial meningioma patients during long-term follow-up

et al. 2023

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“…Even where resources are not as limited surgical costs although initially higher compared with radiotherapy, tend to balance out over time. [ 37 ] Meningiomas are potentially curable and little additional investment in infrastructure will achieve this for majority of Nigerian patients with cranial meningioma. The case for more investment in health infrastructure and the development of a viable health insurance scheme has been argued by Ohaegbulam et al .…”

Section: Discussionmentioning

confidence: 99%

Management of intracranial meningiomas in Enugu, Nigeria

Mezue

Ohaegbulam²,

Ndubuisi³

et al. 2012

Surg Neurol Int

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Background:Meningiomas may range on presentation from incidentally identified small lesions to large symptomatic tumors in eloquent areas of the brain. Management options correspondingly vary and include careful observation, surgical excision, and palliative application of very limited therapeutic maneuvers in select cases. This paper discusses the options and difficulties in the management of meningiomas in a developing country.Methods:This study is a retrospective analysis of prospectively recorded data of patients managed for intracranial meningioma between January 2006 and September 2011 at Memfys Hospital for Neurosurgery, Enugu. Radiographic diagnosis of meningioma was based on computed tomography (CT) and or magnetic resonance imaging (MRI) criteria in all cases, but only patients who had surgery and a histological diagnosis were analyzed.Results:Seventy-four patients were radiographically diagnosed with intracranial meningioma over the period under review. Fifty-five patients were operated upon and 52 (70.3%) with histological diagnosis of meningioma were further analyzed. Histological diagnosis was complete in 42 (56.8%) patients and in 10 (13.5%) patients the subtype of meningioma was not determined. The male to female ratio was 1:1.08. The peak age range for females was in the 6th decade and for males in the 5th decade. The locations were olfactory groove (26.9%), convexity (21.2%), parasagittal/falx (19.2%), sphenoid ridge (15.4%), tuberculum sellae (7.7%), tentorial (3.8%), and posterior fossa (5.8%). The most common clinical presentation was headaches in 67.3% followed by seizures (40.4%) and visual impairment (38.5%). Histology was benign (World Health Organization [WHO] grade 1) in 39 patients. One patient harbored an atypical and two had anaplastic tumors. Gross total resection of the tumor was achieved in 41 patients. Surgical mortality was 3.9%.Conclusion:Effective management of meningioma depends largely on adequate and complete surgical resection and results in good outcomes. Adequate preoperative assessment, including visual assessment, and hormonal assessment in olfactory groove and sphenoid region meningiomas, is necessary.

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Section: Methodsmentioning

confidence: 99%

“…The micro-costing methodology is considered the most accurate approach for costing hospital services ( 24 ). It makes it possible to identify all the resources used within hospital production processes and per patient ( 24 ). In our micro-costing study, we defined the production process as being from treatment planning to the last radiation therapy (RT) session.…”

Section: Methodsmentioning

confidence: 99%

Cost and Toxicity Comparisons of Two IMRT Techniques for Prostate Cancer: A Micro-Costing Study and Weighted Propensity Score Analysis Based on a Prospective Study

et al. 2022

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BackgroundIntensity modulated radiation therapy (IMRT) combined with androgen deprivation therapy (ADT) has become the standard treatment for patients with high-risk prostate cancer. Two techniques of rotational IMRT are commonly used in this indication: Volumetric Modulated Arc Therapy (VMAT) and helical tomotherapy (HT). To the best of our knowledge, no study has compared their related costs and clinical effectiveness and/or toxicity in prostate cancer. We aimed to assess differences in costs and toxicity between VMAT and HT in patients with high-risk prostate cancer with pelvic irradiation.Material and MethodsWe used data from the “RCMI pelvis” prospective multicenter study (NCT01325961) including 155 patients. We used a micro-costing methodology to identify cost differences between VMAT and HT. To assess the effects of the two techniques on total actual costs per patient and on toxicity we used stabilized inverse probability of treatment weighting.ResultsThe mean total cost for HT, €2019 3,069 (95% CI, 2,885–3,285) was significantly higher than the mean cost for VMAT €2019 2,544 (95% CI, 2,443–2,651) (p <.0001). The mean ± SD labor and accelerator cost for HT was €2880 (± 583) and €1978 (± 475) for VMAT, with 81 and 76% for accelerator, respectively. Acute GI and GU toxicity were more frequent in VMAT than in HT (p = .021 and p = .042, respectively). Late toxicity no longer differed between the two groups up to 24 months after completion of treatment.ConclusionUse of VMAT was associated with lower costs for IMRT planning and treatment than HT. Similar stabilized long-term toxicity was reported in both groups after higher acute GI and GU toxicity in VMAT. The estimates provided can benefit future modeling work like cost-effectiveness analysis.

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A microcosting study of microsurgery, LINAC radiosurgery, and gamma knife radiosurgery in meningioma patients

Cited by 8 publications

References 23 publications

Healthcare utilization and costs among intracranial meningioma patients during long-term follow-up

Healthcare utilization and costs among intracranial meningioma patients during long-term follow-up

Management of intracranial meningiomas in Enugu, Nigeria

Cost and Toxicity Comparisons of Two IMRT Techniques for Prostate Cancer: A Micro-Costing Study and Weighted Propensity Score Analysis Based on a Prospective Study

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