3-week RT helps cut costs in glioblastoma treatment

In older adults with glioblastoma, 3-week radiotherapy (RT) lowers out-of-pocket (OOP) cost by about 5 percent compared with 6-week RT, according to a study.

Treatment charges were as follows: neurosurgery, neuro-oncology, and radiation oncology consultations; follow-up; diagnostic imaging; RT planning and delivery; systemic therapy; laboratory monitoring; and tumour-treating fields.

Under Original Medicare, beneficiaries pay 20 percent of Medicare Part B charger after the deductible, with no annual OOP cap, as well as prescription drug expenses under Part D. OOP costs were higher for 30- vs 15-fraction RT. Beneficiaries of Medigap Plan G incurred OOP costs of $2,332.04 for 30-fraction RT and $2,319.42 for 15-fraction RT.

All approved services were covered by Medicaid.

“Incorporating financial considerations into treatment discussions may help reduce the economic burden of glioblastoma care and support shared decision-making,” the authors said.

In this study, standard treatment protocols were defined using the National Comprehensive Cancer Network guidelines, including surgical resection, adjuvant RT, and concurrent and adjuvant temozolomide for 12 cycles.

The authors constructed a 2-year cost model for a Medicare- and/or Medicaid-eligible patient with glioblastoma aged ≥65 years. They calculated aggregate OOP costs by summing deductibles, copayments, and coinsurance under Medicaid, Original Medicare, Medigap Plan G, and Medicare Part D.

“The optimal RT duration for older adults with glioblastoma—6 weeks (60 Gy/30 fractions) vs 3 weeks (40 Gy/15 fractions)—remains debated,” the authors said. “Level 1 evidence demonstrates no significant difference in survival between these regimens.”