Methodological aspects of economic evaluations and health economic models in glioblastoma: A systematic literature review

Abstract Background Glioblastoma is considered one of the deadliest malignant solid tumors. The disease severity and the treatment intensity place a significant burden on patients, their family and caregivers, and the health systems. This study aimed to review the methodological aspects and quality of economic evaluations and health economic models in glioblastoma with a special focus on Europe and North America. Methods A search was performed covering Medline (via PubMed), Embase, Scopus, Cochrane Library, and PROSPERO. Gray literature search and snowball sampling were also conducted. Studies were eligible if they included glioblastoma patients, contained data on economic evaluations, and were in our geographical focus. The protocol was registered in PROSPERO (ID: CRD42023488181). Results The review of 4052 records resulted in 19 peer-reviewed articles, 1 health technology assessment agency document, 2 conference posters, and 1 thesis. Most studies investigated pharmaceuticals in combination with radiotherapy (n = 7). Five studies focused on tumor-treating fields in combination with maintenance temozolomide. Most studies investigated newly diagnosed patients (n = 18). Economic modeling was used in 15 cases; the majority used the "traditional" 3-state Markov cohort or partitioned-survival modeling approach (health states: progression-free, progressed, dead). Input data, particularly for utilities, were outdated in many cases. We identified only 2 studies with societal perspective, and these had limited scope. Conclusion Our review identified gaps in the literature related to the economic evaluations on relapsed glioblastoma patients and to comprehensive assessments using a societal perspective. We also concluded that there is a lack of relevant, high-quality, and up-to-date utility data for glioblastoma in the studies.