OBJECTIVES: Glioblastoma (GBM) is the most aggressive and common primary brain malignancy. TTFields, a novel therapy that can be added to chemotherapy for the treatment of GBM, has proven efficacy in GBM treatment. At present, the evidence on health economics evaluation of TTFields therapy is limited. The objective of the study is to evaluate the cost-effectiveness of TTFields+TMZ compared with TMZ in newly-diagnosed GBM patients and provide economic evidence as a framework for policy and decision making in GBM treatment from Chinese context.

METHODS: Outcomes for newly-diagnosed GBM patients were estimated over a lifetime horizon using partitioned survival model with three states: progression free state, progressed state, or death. The survival model was based on a . The long-term survival data were from GBM epidemiology literatures. Adverse event rates were derived from the EF-14 trial data, the pivotal Phase 3 study of TTFields in patients newly diagnosed with GBM. Cost data was obtained from the public literatures and database, which was validated by expert consultation. Utility values were obtained from published literature. Expected costs and quality adjusted life years (QALYs) of 15 years were calculated through Microsoft Excel from health system perspective. The willingness-to-pay threshold was 3-times the Chinese per capita Gross Domestic Product (GDP) in 2021, 242,928 CNY/QALY. A 5% discount rate was applied to costs and utilities. The results were analyzed by one-way and probabilistic sensitivity analyses.

RESULTS: TTFields+TMZ was estimated to result in a mean increase of 682,206 CNY cost and 2.99 QALYs compared to TMZ alone. The incremental cost-effectiveness ratio (ICER) was 228,086 CNY per QALY gained. . Probability sensitivity analysis indicates that under the existing threshold, the probability of TTFields+TMZ being economical is 71.0%.

CONCLUSIONS: The present cost-effectiveness analysis showed that adding TTFields to maintenance TMZ for newly-diagnosed GBM patients is cost-effective at a threshold 3-times the Chinese per capita GDP.