The economics of temozolomide in brain cancer.

For 30 years, nitrosourea was the only adjuvant treatment available for aggressive glioma patients, despite its severe side effects; and, therefore, radiotherapy was often the therapy of choice. Survival prospect in these patients was, however, low with generally few patients surviving beyond 2 years. Recently, temozolomide was successfully tested in a number of randomised clinical trials and showed an increased survival. As many countries are considering reimbursement or have granted a market authorisation for temozolomide, a number of studies have been published in various countries in order to assess the cost-effectiveness of temozolomide for glioma patients in first- or second-line treatment. These studies show that in general, the incremental cost-effectiveness of temozolomide as adjuvant treatment, albeit at the higher end of commonly accepted thresholds, falls in line with other accepted cancer treatments.