OBJECTIVES: To evaluate healthcare resource utilisation (HRU) and economic burden of Glioblastoma (GBM) in the United States (US).

METHODS: A comprehensive literature search was conducted on biomedical databases – EMBASE, MEDLINE, PubMed and Cochrane Library by combination of Emtree/MeSH terms and keywords from inception to January 2020. Web based searches and bibliography of included studies were also conducted. Quality assessment was performed by using Newcastle-Ottawa-Scale (NOS). Cost data was adjusted to 2018 USD using the world bank consumer price index (CPI) of the US.

RESULTS: Total annual mean direct cost per patient was $425,177 (first-line therapy: $170,067; second-line therapy: $255,110). Annual mean costs per patient was $230,797 for chemotherapy, $65,510 for radiotherapy, $32,479 for inpatient, $4,026 for emergency, $26,062 for pharmacy services and $66,303 for others medical services. The drivers of increased total annual mean direct costs were being male, residents of West and Midwest census, ≥3 Charlson comorbidity index (CCI) score, radiation therapy recipients, readmission ≤7 days after discharge, ≥2 emergency department (ED) visits, hospitalisation for ≥2 weeks, presence of ≥7 MRI scans, and coverage by commercial payers. Median number of ED and out-patients visits and length of stay (LOS) ranges from 1-2, 19-22 and 5-10 days, respectively. Mean hospitalisation ranges from 0.27-2.7 days. In hospital (p=<0.0001) and intensive care unit (p=0.01) mean LOS (in days) was significantly higher in Medicaid (6.89 and 2.55) than Medicare (4.03 and 1.54) and private (3.93 and 1.85) insurance, respectively. Mean LOS is significantly longer in the elderly group (age ≥70 vs. <70 years at surgery– 8.7 days vs. 5.2 days, respectively; p=0.025)

CONCLUSIONS: HRU and direct cost burden of GBM is substantial in the US. Sufficient evidence is not available on indirect cost and efforts need to be made to generate the evidence to understand the total economic burden of GBM in the US.