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Evidence to Improve Care

5-Aminolevulinic Acid Hydrochloride (5-ALA)–Guided Surgical Resection of High-Grade Gliomas

Final Recommendation

  • The Quality business unit at Ontario Health, based on guidance from the Ontario Health Technology Advisory Committee, recommends publicly funding 5-aminolevulinic acid hydrochloride (5-ALA) for guiding maximal surgical resection of high-grade gliomas, conditional on Health Canada approval of the technology

Read the final recommendation report



High-grade gliomas are a type of fast-growing brain tumour. Treatment for high-grade gliomas involves surgery to remove as much of the tumour as safely as possible to help people feel better and live longer. Removing the brain tumour can be challenging because it is difficult for surgeons to see the difference between the tumour and healthy brain tissue during surgery.

5-aminolevulinic acid hydrochloride (5-ALA) is a drug that is used to help surgeons see the tumour better during surgery and guide its removal. After 5-ALA is administered, areas of the tumour glow pink or red, and healthy brain tissue appears blue, when exposed to a special blue light during surgery.

This health technology assessment looked at how safe and effective 5-ALA–guided surgery is for people with high-grade gliomas. It also looked at the budget impact of publicly funding 5-ALA and the experiences, preferences, and values of an adult who had experience with high-grade glioma, standard surgical treatment, and 5-ALA–guided surgery.

Read the full Health Technology Assessment report for more information.


5-Aminolevulinic Acid Hydrochloride (5-ALA)–Guided Surgical Resection of High-Grade Gliomas: A Health Technology Assessment (PDF)
March 2020

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The Ministry of Health endorses this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review health technology assessments and funding recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.



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