Grade IV glioma (glioblastoma) is one of the most common brain/central nervous 
system cancers. In 2005, the standard of care for adjuvant treatment was 
significantly changed with the approval of temozolomide. Carmustine wafers have 
also gained some popularity. Phase III trials are currently evaluating 
bevacizumab in conjunction with the standard temozolomide regimen. Despite these 
recent advances in pharmacotherapy, roughly two-thirds of patients do not 
survive longer than 2 years after diagnosis. Meanwhile, the costs of treatment 
are substantial. The goal of this study is to review the clinical, 
cost-of-illness, and cost-effectiveness literature relevant to treating 
glioblastoma. Estimates of the economic burden of glioblastoma within different 
healthcare systems were converted to 2013 US dollars. Temozolomide has 
demonstrated a 2.5-month increase in overall survival and a 1.9-month increase 
in progression-free survival, relative to radiotherapy alone. Carmustine wafers 
have also been shown to increase overall survival by 2.3 months, compared with 
placebo wafers. Cost-effectiveness studies of temozolomide have produced 
incremental cost-effectiveness ratios, adjusted to 2013 US dollars, with a range 
from US$73,586 per quality-adjusted life-year (QALY) (UK National Health Service 
perspective) to US$105,234 per QALY (US societal perspective). More research is 
needed to quantify the full societal burden of illness.