P16.03.A FROM INNOVATION TO INSOLVENCY? EVALUATING THE ECONOMIC BURDEN AND PATIENT-INFORMED POLICY STRATEGIES FOR GLIOBLASTOMA MANAGEMENT IN ASIA

Abstract BACKGROUND Glioblastoma (GBM) treatment innovations, while promising, pose significant economic challenges in Asia’s low-resource settings, where financial toxicity undermines adherence and quality of life (QoL). Engaging patients in policy-making can ensure equitable access to cost-effective care. This study, the first comprehensive synthesis of GBM cost-effectiveness in Asia, evaluates therapies and patient-informed strategies to reduce financial burdens in low- and middle-income countries (LMICs). MATERIAL AND METHODS A systematic review was conducted through multiple databases including PubMed, Cochrane, Science Direct, Scopus, and Wiley Online Library (2000-2025). A total of 26 studies on GBM healthcare costs, cost-effectiveness (e.g., ICERs), and financial burden in Asia and LMIC were included. Inclusion criteria targeted economic evaluations and patient access studies. The CHEERS checklist guided quality assessment. Comparative ICER analysis was supplemented by qualitative synthesis of patient-level and system-level barriers, including patient perspectives on policy needs. RESULTS Cost-effective therapies, such as temozolomide (ICER: $2,100/QALY in India) and awake craniotomy in Pakistan, consistently reduced costs and improved access across LMICs. Hypofractionated radiotherapy saved $3,200 per elderly patient in South Korea. In contrast, high-cost therapies like Tumor Treating Fields and bevacizumab were unaffordable in China, limiting their use. Annual treatment costs, ranging from $15,000 (Oman) to $45,000 (Japan), often led to discontinuation. Systemic barriers, including a shortage of 500 neurosurgeons in South Asia and limited molecular testing (9.4% of LMIC centers with NGS), hindered personalized care. Patients prioritized subsidies and transparent reimbursement to enhance access. CONCLUSION Cost-effective therapies, including temozolomide, awake craniotomy, and hypofractionated radiotherapy, are essential for sustainable GBM care in Asia’s LMICs. Engaging patients in designing subsidy programs and transparent reimbursement models mitigates financial toxicity and promotes equitable access. Health systems must invest in addressing systemic barriers, such as neurosurgical workforce shortages and diagnostic limitations, through value-based policy reforms to improve outcomes and QoL.