OBJECTIVE: This study evaluates the cost-effectiveness of 5-aminolevulinic acid 
(5-ALA, Gliolan®) in patients undergoing surgery for malignant glioma, in 
standard clinical practice conditions in Spain.
MATERIAL AND METHODS: Cost-effectiveness ratios were determined in terms of 
incremental cost per complete resection (CR) and incremental cost per additional 
quality-adjusted life year (QALY), based on data collected in the VISIONA 
observational study.
RESULTS: Incremental cost with 5-ALA versus conventional surgery using white 
light only amounts to € 4550 per additional CR achieved and € 9021 per QALY 
gained. A sensitivity analysis shows these results to be robust.
CONCLUSION: Malignant glioma surgery guided by 5-ALA fluorescence entails a 
moderate increase in hospital costs compared to current surgical practice and 
can be considered a cost-effective innovation.