The Economic and Humanistic Burden of Glioma in the United States and Canada

OBJECTIVES: Gliomas are the most common brain tumor in adults in the United States (US) and Canada; they are highly detrimental to patient quality of life (QoL) and treatment incurs substantial costs. A systematic literature review (SLR) was conducted to synthesize economic and humanistic burden data and review unmet needs in patients with glioma in Northern America to inform clinical and economic decision-making.

METHODS: An SLR was conducted in PubMed and Embase in April 2023 and updated in January 2024.

RESULTS: Reported per-patient costs were heterogeneous but consistently high, ranging from 6-month costs of US$117,325–126,128 for glioblastoma to US$184,160 in overall insurance payments for high-grade glioma (HGG). Even for low-grade gliomas (LGG), costs reached US$39,043–40,661 for index procedures and US$43,219–56,093 for 90 days after surgery. In Canada, direct costs from diagnosis of glioblastoma to death were US$14,110; however, economic (and other burden) data for Canada are sparse. Regarding humanistic impact, glioma was reported to be associated with impaired post-surgery QoL for LGG, reduced long-term cognitive and daily functioning in glioma survivors, and frequent distress in caregivers. The review highlighted suboptimal treatment patterns in the US. Up to 22% of patients with newly-diagnosed glioblastoma did not receive cancer-related treatment. Of patients resected for anaplastic astrocytoma, 15% received no adjunct treatment, while only 22% of patients with HGG received palliative care consultations. Care disparities were dependent on demographic and socioeconomic factors: elderly, Hispanic, and uninsured patients were less likely to receive appropriate care, as were patients living in counties in the Midwest, without neurosurgeons, and with higher proportions of Black patients.

CONCLUSIONS: Glioma poses an economic and humanistic challenge to patients and healthcare systems in Northern America. Enhancing treatment options and ensuring broader, equitable healthcare access could contribute to improving patient outcomes and alleviating the disease burden.