Cost-Effectiveness of Proton Beam Therapy in the Treatment of Pediatric Medulloblastoma in France
Author(s)
Alejandra Duenas, PhD1, Christine Di Martinelly, PhD2, Joaquin Aguado, PhD3.
1Professor, ICN Business School, Universite de Lorraine, CEREFIGE, NANCY, France, 2IESEG School of Managementt, LEM‐CNRS (UMR 9221), Lille, France, 3University of Bamberg, Bamberg, Germany.
1Professor, ICN Business School, Universite de Lorraine, CEREFIGE, NANCY, France, 2IESEG School of Managementt, LEM‐CNRS (UMR 9221), Lille, France, 3University of Bamberg, Bamberg, Germany.
OBJECTIVES: Medulloblastoma is the most common malignant brain tumor in children, representing 20% of central nervous system tumors among this age group. In addition to surgery, radiation therapy (RT) remains a crucial option for treating patients with medulloblastoma. Nonetheless, it carries the risk of late adverse events. These negative events lead to neurocognitive and endocrine impairments affecting almost all patients. The objective of the current study was to assess the cost-effectiveness of proton beam therapy compared with conventional radiation therapy in the treatment of childhood medulloblastoma from the perspective of the national health insurance system in France.
METHODS: A Markov model was developed with hypothyroidism, hearing loss, growth hormone deficiency, IQ loss and secondary cancer as health states. The time horizon is the lifetime, with quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) used as outcomes. The utility scores and costs were estimated from the literature for the French population.
RESULTS: With a willingness to pay threshold of €50,000 and an ICER of €5,236/QALY, proton beam therapy is suggested to be cost-effective. Sensitivity analyses were performed, in which the model's parameters were varied, and it was shown that growth hormone deficiency can contribute to a reduction in costs.
CONCLUSIONS: The results of this study indicated that proton radiation therapy can be cost-effective compared with conventional radiation therapy in the treatment of children with medulloblastoma. However, much more information on the long-term consequences of radiation therapy is needed. Additionally, there is a need to consider different health states from a public health perspective, which includes the capacity of these patients to lead a normal adult life after treatment.
METHODS: A Markov model was developed with hypothyroidism, hearing loss, growth hormone deficiency, IQ loss and secondary cancer as health states. The time horizon is the lifetime, with quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) used as outcomes. The utility scores and costs were estimated from the literature for the French population.
RESULTS: With a willingness to pay threshold of €50,000 and an ICER of €5,236/QALY, proton beam therapy is suggested to be cost-effective. Sensitivity analyses were performed, in which the model's parameters were varied, and it was shown that growth hormone deficiency can contribute to a reduction in costs.
CONCLUSIONS: The results of this study indicated that proton radiation therapy can be cost-effective compared with conventional radiation therapy in the treatment of children with medulloblastoma. However, much more information on the long-term consequences of radiation therapy is needed. Additionally, there is a need to consider different health states from a public health perspective, which includes the capacity of these patients to lead a normal adult life after treatment.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE269
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Disease
Oncology, Pediatrics