THE SOCIOECONOMIC BURDEN OF IDH-MUTANT GRADE 2 GLIOMA: QUANTIFYING PATIENT AND CAREGIVER PRODUCTIVITY LOSSES IN SPAIN
Author(s)
Paula Pereira, PhD1, Carmen Balaña Quintero, MD, PhD2, Cristóbal Belda Iniesta, MD, PhD3, Jon Andoni Duñabeitia Landaburu, Prof, PhD4, Inmaculada Fortes de la Torre, MD5, Juan Oliva-Moreno, Cat.6, Jose Luis Trillo, PhD7, Marvin Melo Maldonado, MSc8, Ruth Graefenhain de Codes, MSc8, Jorge Mestre-Ferrandiz, BA, MSc, PhD1.
1Weber, Madrid, Spain, 2Badalona Applied Research Group in Oncology (B-ARGO Group), Institut Investigació Germans Trias i Pujol (IGTP), Badalona, Spain, 3HM Hospitales, Madrid, Spain, 4International Chair in Cognitive Health (ICCH), Universidad Nebrija, Madrid, Spain, 5Hospital Regional Universitario de Málaga, Málaga, Spain, 6Ciencias Jurídicas y Sociales, Universidad Castilla-La Mancha, Toledo, Spain, 7Servicio de Prestación Farmacéutica, Conselleria de Sanidad de Valencia, Valencia, Spain, 8Servier, Madrid, Spain.
1Weber, Madrid, Spain, 2Badalona Applied Research Group in Oncology (B-ARGO Group), Institut Investigació Germans Trias i Pujol (IGTP), Badalona, Spain, 3HM Hospitales, Madrid, Spain, 4International Chair in Cognitive Health (ICCH), Universidad Nebrija, Madrid, Spain, 5Hospital Regional Universitario de Málaga, Málaga, Spain, 6Ciencias Jurídicas y Sociales, Universidad Castilla-La Mancha, Toledo, Spain, 7Servicio de Prestación Farmacéutica, Conselleria de Sanidad de Valencia, Valencia, Spain, 8Servier, Madrid, Spain.
OBJECTIVES: To quantify indirect costs and health-related quality-of-life losses associated with IDH-mutant grade 2 glioma in Spain from a broad societal perspective and identify key cost drivers relevant to HTA and treatment decision-making.
METHODS: A stage-based cost model was constructed using primary data from a multidisciplinary expert panel and a patient focus group, supplemented by published evidence. Five stages were defined: post-surgical; initial watchful waiting (WW-1); first radiotherapy/chemotherapy (RT/CT-1); second watchful waiting (WW-2); second chemotherapy (CT-2). Patient and caregiver productivity losses were estimated by the human capital method per stage. Informal care was valued via replacement cost method applying the hourly cost of home help services (16,21€/h), anchored to dependency grades estimated by expert panel. QALY losses were derived from published utility values using available evidence on possible Spanish willingness-to-pay thresholds for one QALY (reference value 28.250€/QALY). Out-of-pocket expenditure was mapped qualitatively.
RESULTS: Patient productivity losses ranged from 3.465€/year (WW-1) to 12.802€ (WW-2). Cumulative first four years indirect costs under a surgery-WW strategy were 21.137€, versus 76.461-87.746€ under surgery-immediate RT/CT (x3,5-4 higher). Monthly patient costs escalated from 289€ (WW-1) to 1.067€ post-RT/CT (WW-2) and to 1.336€ combined with caregivers, approximately 3,7x higher than WW-1, reflecting lasting RT/CT sequelae. Informal care needs during severe-dependency stages reached 75-96 h/week (1.216-1.556€/week). Stable disease without chemotherapy represented an annual HRQoL gain of 6.215€/patient. Out-of-pocket expenditure on psychotherapy and cognitive rehabilitation represented an additional burden reflecting gaps in public health coverage.
CONCLUSIONS: IDH-mutant grade 2 glioma imposes a substantial indirect cost burden on patients, caregivers and society. RT/CT is the primary driver of cost escalation, directly and through persistent post-treatment productivity losses. From a societal perspective, therapeutic strategies that delay RT/CT while preserving disease control and HRQoL generate significant economic value beyond their clinical benefit, strengthening the case for HTA evaluation.
METHODS: A stage-based cost model was constructed using primary data from a multidisciplinary expert panel and a patient focus group, supplemented by published evidence. Five stages were defined: post-surgical; initial watchful waiting (WW-1); first radiotherapy/chemotherapy (RT/CT-1); second watchful waiting (WW-2); second chemotherapy (CT-2). Patient and caregiver productivity losses were estimated by the human capital method per stage. Informal care was valued via replacement cost method applying the hourly cost of home help services (16,21€/h), anchored to dependency grades estimated by expert panel. QALY losses were derived from published utility values using available evidence on possible Spanish willingness-to-pay thresholds for one QALY (reference value 28.250€/QALY). Out-of-pocket expenditure was mapped qualitatively.
RESULTS: Patient productivity losses ranged from 3.465€/year (WW-1) to 12.802€ (WW-2). Cumulative first four years indirect costs under a surgery-WW strategy were 21.137€, versus 76.461-87.746€ under surgery-immediate RT/CT (x3,5-4 higher). Monthly patient costs escalated from 289€ (WW-1) to 1.067€ post-RT/CT (WW-2) and to 1.336€ combined with caregivers, approximately 3,7x higher than WW-1, reflecting lasting RT/CT sequelae. Informal care needs during severe-dependency stages reached 75-96 h/week (1.216-1.556€/week). Stable disease without chemotherapy represented an annual HRQoL gain of 6.215€/patient. Out-of-pocket expenditure on psychotherapy and cognitive rehabilitation represented an additional burden reflecting gaps in public health coverage.
CONCLUSIONS: IDH-mutant grade 2 glioma imposes a substantial indirect cost burden on patients, caregivers and society. RT/CT is the primary driver of cost escalation, directly and through persistent post-treatment productivity losses. From a societal perspective, therapeutic strategies that delay RT/CT while preserving disease control and HRQoL generate significant economic value beyond their clinical benefit, strengthening the case for HTA evaluation.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE536
Topic
Economic Evaluation, Patient-Centered Research
Topic Subcategory
Work & Home Productivity - Indirect Costs
Disease
Oncology, Rare & Orphan Diseases