1. Cost-effectiveness of proton beam therapy vs. conventional radiotherapy for patients with brain tumors in Sweden: results from a non-randomized prospective multicenter study.
- Author
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Sampaio, Filipa, Langegård, Ulrica, de Alva, Patricio Martínez, Flores, Sergio, Nystrand, Camilla, Fransson, Per, Ohlsson-Nevo, Emma, Kristensen, Ingrid, Sjövall, Katarina, Feldman, Inna, and Ahlberg, Karin
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PROTON therapy , *MEDICAL care use , *QUALITY-adjusted life years , *COST effectiveness , *RADIOTHERAPY , *RESEARCH funding , *HOSPITAL care , *OUTPATIENT medical care , *ANTINEOPLASTIC agents , *QUESTIONNAIRES , *CANCER patients , *DESCRIPTIVE statistics , *TREATMENT effectiveness , *LONGITUDINAL method , *RESEARCH , *COMPARATIVE studies , *DRUGS , *CONFIDENCE intervals , *BRAIN tumors , *MEDICAL care costs - Abstract
Background: This study assessed the cost-effectiveness of proton beam therapy (PBT) compared to conventional radiotherapy (CRT) for treating patients with brain tumors in Sweden. Methods: Data from a longitudinal non-randomized study performed between 2015 and 2020 was used, and included adult patients with brain tumors, followed during treatment and through a one-year follow-up. Clinical and demographic data were sourced from the longitudinal study and linked to Swedish national registers to get information on healthcare resource use. A cost-utility framework was used to evaluate the cost-effectiveness of PBT vs. CRT. Patients in PBT group (n = 310) were matched with patients in CRT group (n = 40) on relevant observables using propensity score matching with replacement. Costs were estimated from a healthcare perspective and included costs related to inpatient and specialized outpatient care, and prescribed medications. The health outcome was quality-adjusted life-years (QALYs), derived from the EORTC-QLQ-C30. Generalized linear models (GLM) and two-part models were used to estimate differences in costs and QALYs. Results: PBT yielded higher total costs, 14,639 US$, than CRT, 13,308 US$, with a difference of 1,372 US$ (95% CI, -4,914–7,659) over a 58 weeks' time horizon. Further, PBT resulted in non-significantly lower QALYs, 0.746 compared to CRT, 0.774, with a difference of -0.049 (95% CI, -0.195–0.097). The probability of PBT being cost-effective was < 30% at any willingness to pay. Conclusions: These results suggest that PBT cannot be considered a cost-effective treatment for brain tumours, compared to CRT. Trial registration: Not applicable. Novelty and Impact: This study informs on the cost-effectiveness of proton beam therapy (PBT) versus conventional radiotherapy (CRT) for patients with brain tumors in Sweden. Amidst global concerns regarding the cost-effectiveness of PBT, our investigation fills a notable gap by providing evidence from the Swedish healthcare landscape. Using real-world data, our study demonstrates the application of established health economic methodology to compare PBT and CRT for brain tumors, furthering research in this area. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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