The cost-effectiveness of stereotactic radiosurgery versus surgical resection in the treatment of brain metastasis in Vietnam from the perspective of patients and families

Duong Anh Vuong; Dirk Rades; Anh Ngoc Le; Reinhard Busse

doi:10.1016/j.wneu.2011.05.050

The cost-effectiveness of stereotactic radiosurgery versus surgical resection in the treatment of brain metastasis in Vietnam from the perspective of patients and families

Duong Anh Vuong^*, Dirk Rades, Anh Ngoc Le, Reinhard Busse

^*Corresponding author for this work

Clinic of Radiotherapy

Technische Universität Berlin

22 Citations (Scopus)

Abstract

Background: This study aims to evaluate the cost-effectiveness of the treatment of brain metastasis with surgical resection (SR) and stereotactic radiosurgery (SRS) in the lower-middle-income country of Vietnam from the perspective of patients and families. Methods: The treatment of 111 patients with brain metastases who underwent SR (n = 64) and SRS (n = 47) was retrospectively reviewed. Propensity score matching was used to adjust for selection bias (n = 30 each); mean and curves of survival time were defined by the Kaplan-Meier estimator; the cost analysis focused on the time period of relevant treatment. Results: The mean survival times of SRS and SR were 11.9 and 10.5 months, and the 18-month survival rates were 32% and 14%, respectively (P = 0.346). The mean number of hospital bed days was significantly higher for SR than SRS (16.5 versus 7.6 days, P < 0.05), but direct costs of SR were significantly lower (14.5 as opposed to 35.3 million Vietnamese dong [VND] per patient, P < 0.001). However, indirect costs of SR were 10 times higher (26.0 versus 2.5 million VND per patient, P < 0.001). The cost per life year gained was higher for SR than SRS (46.4 and 38.1 million VND, respectively). Conclusions: SRS is similarly effective as SR. However, in the broader context of the cost-effectiveness from the perspective of patients and their families, SRS is more cost-effective. The lower costs directly charged by the hospital for SR may prevent poorer and older patients from choosing SRS. Thus, the overall cost-effectiveness of each treatment option should be taken into consideration in deciding on the treatment.

Original language	English
Journal	World Neurosurgery
Volume	77
Issue number	2
Pages (from-to)	321-328
Number of pages	8
ISSN	1878-8750
DOIs	https://doi.org/10.1016/j.wneu.2011.05.050
Publication status	Published - 02.2012

Funding

The authors acknowledge the scholarship provided by the Ministry of Education and Training of Vietnam and German Academic Exchange Service, Choray Hospital, Vietnam–Germany Friendship Hospital, and Hue Medical University Hospital for kindly allowing the authors to use the datasets of their patients, and are grateful to Michael Bäumler (Berlin University of Technology), and three anonymous reviewers for valuable comments on an earlier draft of this article. Any remaining errors are the responsibility of the authors.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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10.1016/j.wneu.2011.05.050

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title = "The cost-effectiveness of stereotactic radiosurgery versus surgical resection in the treatment of brain metastasis in Vietnam from the perspective of patients and families",

abstract = "Background: This study aims to evaluate the cost-effectiveness of the treatment of brain metastasis with surgical resection (SR) and stereotactic radiosurgery (SRS) in the lower-middle-income country of Vietnam from the perspective of patients and families. Methods: The treatment of 111 patients with brain metastases who underwent SR (n = 64) and SRS (n = 47) was retrospectively reviewed. Propensity score matching was used to adjust for selection bias (n = 30 each); mean and curves of survival time were defined by the Kaplan-Meier estimator; the cost analysis focused on the time period of relevant treatment. Results: The mean survival times of SRS and SR were 11.9 and 10.5 months, and the 18-month survival rates were 32\% and 14\%, respectively (P = 0.346). The mean number of hospital bed days was significantly higher for SR than SRS (16.5 versus 7.6 days, P < 0.05), but direct costs of SR were significantly lower (14.5 as opposed to 35.3 million Vietnamese dong [VND] per patient, P < 0.001). However, indirect costs of SR were 10 times higher (26.0 versus 2.5 million VND per patient, P < 0.001). The cost per life year gained was higher for SR than SRS (46.4 and 38.1 million VND, respectively). Conclusions: SRS is similarly effective as SR. However, in the broader context of the cost-effectiveness from the perspective of patients and their families, SRS is more cost-effective. The lower costs directly charged by the hospital for SR may prevent poorer and older patients from choosing SRS. Thus, the overall cost-effectiveness of each treatment option should be taken into consideration in deciding on the treatment.",

author = "Vuong, \{Duong Anh\} and Dirk Rades and Le, \{Anh Ngoc\} and Reinhard Busse",

note = "Funding Information: The authors acknowledge the scholarship provided by the Ministry of Education and Training of Vietnam and German Academic Exchange Service, Choray Hospital, Vietnam–Germany Friendship Hospital, and Hue Medical University Hospital for kindly allowing the authors to use the datasets of their patients, and are grateful to Michael B{\"a}umler (Berlin University of Technology), and three anonymous reviewers for valuable comments on an earlier draft of this article. Any remaining errors are the responsibility of the authors. Copyright: Copyright 2012 Elsevier B.V., All rights reserved.",

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doi = "10.1016/j.wneu.2011.05.050",

language = "English",

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T1 - The cost-effectiveness of stereotactic radiosurgery versus surgical resection in the treatment of brain metastasis in Vietnam from the perspective of patients and families

AU - Vuong, Duong Anh

AU - Rades, Dirk

AU - Le, Anh Ngoc

AU - Busse, Reinhard

N1 - Funding Information: The authors acknowledge the scholarship provided by the Ministry of Education and Training of Vietnam and German Academic Exchange Service, Choray Hospital, Vietnam–Germany Friendship Hospital, and Hue Medical University Hospital for kindly allowing the authors to use the datasets of their patients, and are grateful to Michael Bäumler (Berlin University of Technology), and three anonymous reviewers for valuable comments on an earlier draft of this article. Any remaining errors are the responsibility of the authors. Copyright: Copyright 2012 Elsevier B.V., All rights reserved.

PY - 2012/2

Y1 - 2012/2

N2 - Background: This study aims to evaluate the cost-effectiveness of the treatment of brain metastasis with surgical resection (SR) and stereotactic radiosurgery (SRS) in the lower-middle-income country of Vietnam from the perspective of patients and families. Methods: The treatment of 111 patients with brain metastases who underwent SR (n = 64) and SRS (n = 47) was retrospectively reviewed. Propensity score matching was used to adjust for selection bias (n = 30 each); mean and curves of survival time were defined by the Kaplan-Meier estimator; the cost analysis focused on the time period of relevant treatment. Results: The mean survival times of SRS and SR were 11.9 and 10.5 months, and the 18-month survival rates were 32% and 14%, respectively (P = 0.346). The mean number of hospital bed days was significantly higher for SR than SRS (16.5 versus 7.6 days, P < 0.05), but direct costs of SR were significantly lower (14.5 as opposed to 35.3 million Vietnamese dong [VND] per patient, P < 0.001). However, indirect costs of SR were 10 times higher (26.0 versus 2.5 million VND per patient, P < 0.001). The cost per life year gained was higher for SR than SRS (46.4 and 38.1 million VND, respectively). Conclusions: SRS is similarly effective as SR. However, in the broader context of the cost-effectiveness from the perspective of patients and their families, SRS is more cost-effective. The lower costs directly charged by the hospital for SR may prevent poorer and older patients from choosing SRS. Thus, the overall cost-effectiveness of each treatment option should be taken into consideration in deciding on the treatment.

AB - Background: This study aims to evaluate the cost-effectiveness of the treatment of brain metastasis with surgical resection (SR) and stereotactic radiosurgery (SRS) in the lower-middle-income country of Vietnam from the perspective of patients and families. Methods: The treatment of 111 patients with brain metastases who underwent SR (n = 64) and SRS (n = 47) was retrospectively reviewed. Propensity score matching was used to adjust for selection bias (n = 30 each); mean and curves of survival time were defined by the Kaplan-Meier estimator; the cost analysis focused on the time period of relevant treatment. Results: The mean survival times of SRS and SR were 11.9 and 10.5 months, and the 18-month survival rates were 32% and 14%, respectively (P = 0.346). The mean number of hospital bed days was significantly higher for SR than SRS (16.5 versus 7.6 days, P < 0.05), but direct costs of SR were significantly lower (14.5 as opposed to 35.3 million Vietnamese dong [VND] per patient, P < 0.001). However, indirect costs of SR were 10 times higher (26.0 versus 2.5 million VND per patient, P < 0.001). The cost per life year gained was higher for SR than SRS (46.4 and 38.1 million VND, respectively). Conclusions: SRS is similarly effective as SR. However, in the broader context of the cost-effectiveness from the perspective of patients and their families, SRS is more cost-effective. The lower costs directly charged by the hospital for SR may prevent poorer and older patients from choosing SRS. Thus, the overall cost-effectiveness of each treatment option should be taken into consideration in deciding on the treatment.

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U2 - 10.1016/j.wneu.2011.05.050

DO - 10.1016/j.wneu.2011.05.050

M3 - Scientific review articles

C2 - 22120377

AN - SCOPUS:84859703606

SN - 1878-8750

VL - 77

SP - 321

EP - 328

JO - World Neurosurgery

JF - World Neurosurgery

IS - 2

ER -

The cost-effectiveness of stereotactic radiosurgery versus surgical resection in the treatment of brain metastasis in Vietnam from the perspective of patients and families

Abstract

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UN SDGs

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