Cost Analysis of Adjuvant Whole‑Brain Radiotherapy Treatment Versus No Whole‑Brain Radiotherapy After Stereotactic Radiosurgery and/or Surgery Among Adults with One to Three Melanoma Brain Metastases: Results from a Randomized Trial
Field | Value | Language |
dc.contributor.author | Tran, Anh Dam | |
dc.contributor.author | Hong, Angela M. | |
dc.contributor.author | Nguyen, Mai T. H. | |
dc.contributor.author | Fogarty, Gerald | |
dc.contributor.author | Steel, Victoria | |
dc.contributor.author | Paton, Elizabeth | |
dc.contributor.author | Morton, Rachael L. | |
dc.date.accessioned | 2023-03-21T02:05:47Z | |
dc.date.available | 2023-03-21T02:05:47Z | |
dc.date.issued | 2022 | en_AU |
dc.identifier.uri | https://hdl.handle.net/2123/30255 | |
dc.description.abstract | Purpose We aimed to compare Australian health system costs at 12 months for adjuvant whole-brain radiotherapy (WBRT) treatment after stereotactic radiosurgery (SRS) and/or surgery versus observation among adults with one to three melanoma brain metastases. We hypothesized that treatment with adjuvant WBRT and subsequent healthcare would be more expensive than SRS/surgery alone. Methods The analysis was conducted alongside a multicentre, randomized phase III trial. A bespoke cost questionnaire was used to measure healthcare use, including hospitalizations, specialist and primary care visits, imaging, and medicines over 12 months. Mean per-patient costs were calculated based on the quantity of resources used and unit costs, reported in Australian dollars ($AU), year 2018 values. Skewness of cost data was determined using normality tests and censor-adjusted costs reported using the Kaplan–Meier sample average method. The analysis of diference in mean costs at each 2-month time point and at 12 months was performed and checked using Kruskal–Wallis, generalized linear models with gamma distribution and log link, modifed Park test, ordinary least squares, and non-parametric bootstrapping. Results In total, 89 patients with similar characteristics at baseline were included in the cost analysis (n = 43 WBRT; n = 46 observation). Hospitalization cost was the main cost, ranging from 63 to 89% of total healthcare costs. The unadjusted 12-monthly cost for WBRT was $AU71,138 ± standard deviation 41,475 and for observation $AU69,848 ± 33,233; p = 0.7426. The censor-adjusted 12-monthly cost for WBRT was $AU90,277 ± 36,274 and $AU82,080 ± 34,411 for observation. There was no signifcant diference in 2-monthly costs between groups (p > 0.30 for all models). Conclusions Most costs were related to inpatient hospitalizations associated with disease recurrence. Adding WBRT after local SRS/surgery for patients with one to three melanoma brain metastases did not signifcantly increase health system costs during the frst 12 months. Trial Registration ACTRN12607000512426, prospectively registered 14 September 2007 | en_AU |
dc.language.iso | en | en_AU |
dc.publisher | PharmacoEconomics - Open | en_AU |
dc.rights | Creative Commons Attribution-NonCommercial 4.0 | en_AU |
dc.subject | Cost analysis | en_AU |
dc.subject | Whole-brain radiotherapy | en_AU |
dc.subject | stereotactic radiosurgery | en_AU |
dc.subject | Melanoma | en_AU |
dc.subject | metastases | en_AU |
dc.subject | Randomized Trial | en_AU |
dc.title | Cost Analysis of Adjuvant Whole‑Brain Radiotherapy Treatment Versus No Whole‑Brain Radiotherapy After Stereotactic Radiosurgery and/or Surgery Among Adults with One to Three Melanoma Brain Metastases: Results from a Randomized Trial | en_AU |
dc.type | Article | en_AU |
dc.identifier.doi | https://doi.org/10.1007/s41669-022-00332-8 | |
dc.type.pubtype | Publisher's version | en_AU |
usyd.faculty | Faculty of Medicine and Health | en_AU |
usyd.department | NHMRC Clinical Trials Centre | en_AU |
workflow.metadata.only | No | en_AU |
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