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Direct costs of radiotherapy for rectal cancer: a microcosting study.

Hanly P, Céilleachair AÓ, Skally M, O'Neill C, Sharp L - BMC Health Serv Res (2015)

Bottom Line: Sensitivity analyses were performed.By simultaneously varying treatment time, capacity utilization rates and linear accelerator staff numbers, the base cost fell by 20% for 5-fractions: (€1,660) and 35% for 25-fractions: (€2,354).Moreover, significant savings may be achievable through service organization and provision changes.

View Article: PubMed Central - PubMed

Affiliation: School of Business, National College of Ireland, Dublin, Ireland. paul.hanly@ncirl.ie.

ABSTRACT

Background: Radiotherapy provides significant benefits in terms of reducing risk of local recurrence and death from rectal cancer. Despite this, up-to-date cost estimates for radiotherapy are lacking, potentially inhibiting policy and decision-making. Our objective was to generate an up-to-date estimate of the cost of traditional radiotherapy for rectal cancer and model the impact of a range of potential efficiency improvements.

Methods: Microcosting methods were used to estimate total direct radiotherapy costs for long- (assumed at 45-50 Gy in 25 daily fractions over a 5 week period) and short-courses (assumed at 25 Gy in 5 daily fractions over a one week period). Following interviews and on-site visits to radiotherapy departments in two designated cancer centers, a radiotherapy care pathway for a typical rectal cancer patient was developed. Total direct costs were derived by applying fixed and variable unit costs to resource use within each care phase. Costs included labor, capital, consumables and overheads. Sensitivity analyses were performed.

Results: Radiotherapy treatment was estimated to cost between €2,080 (5-fraction course) and €3,609 (25-fraction course) for an average patient in 2012. Costs were highest in the treatment planning phase for the short-course (€1,217; 58% of total costs), but highest in the radiation treatment phase for the long-course (€1,974: 60% of total costs). By simultaneously varying treatment time, capacity utilization rates and linear accelerator staff numbers, the base cost fell by 20% for 5-fractions: (€1,660) and 35% for 25-fractions: (€2,354).

Conclusions: Traditional radiotherapy for rectal cancer is relatively inexpensive. Moreover, significant savings may be achievable through service organization and provision changes. These results suggest that a strong economic argument can be made for expanding the use of radiotherapy in rectal cancer treatment.

No MeSH data available.


Related in: MedlinePlus

The impact of efficiency gains on the costs of radiotherapy (€) with percentage deviation from base case costs in brackets. a. 25 fraction course (Each nodal point represents the accumulated cost reduction resulting from the previous efficiency gains). b. 5 fraction course.
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Fig2: The impact of efficiency gains on the costs of radiotherapy (€) with percentage deviation from base case costs in brackets. a. 25 fraction course (Each nodal point represents the accumulated cost reduction resulting from the previous efficiency gains). b. 5 fraction course.

Mentions: Combined incremental variation of treatment time (to 10 minutes), capacity utilization (to 125%) and linear accelerator staff numbers (to 3) resulted in a decrease in the base case estimate of total costs for long-course radiotherapy (25 fractions) of 35%, from €3,609 to €2,354 (Figure 2a). For short-courses, these changes would reduce the estimate of total cost per course by 20%, from €2,080 to €1,660 (Figure 2b).Figure 2


Direct costs of radiotherapy for rectal cancer: a microcosting study.

Hanly P, Céilleachair AÓ, Skally M, O'Neill C, Sharp L - BMC Health Serv Res (2015)

The impact of efficiency gains on the costs of radiotherapy (€) with percentage deviation from base case costs in brackets. a. 25 fraction course (Each nodal point represents the accumulated cost reduction resulting from the previous efficiency gains). b. 5 fraction course.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4494796&req=5

Fig2: The impact of efficiency gains on the costs of radiotherapy (€) with percentage deviation from base case costs in brackets. a. 25 fraction course (Each nodal point represents the accumulated cost reduction resulting from the previous efficiency gains). b. 5 fraction course.
Mentions: Combined incremental variation of treatment time (to 10 minutes), capacity utilization (to 125%) and linear accelerator staff numbers (to 3) resulted in a decrease in the base case estimate of total costs for long-course radiotherapy (25 fractions) of 35%, from €3,609 to €2,354 (Figure 2a). For short-courses, these changes would reduce the estimate of total cost per course by 20%, from €2,080 to €1,660 (Figure 2b).Figure 2

Bottom Line: Sensitivity analyses were performed.By simultaneously varying treatment time, capacity utilization rates and linear accelerator staff numbers, the base cost fell by 20% for 5-fractions: (€1,660) and 35% for 25-fractions: (€2,354).Moreover, significant savings may be achievable through service organization and provision changes.

View Article: PubMed Central - PubMed

Affiliation: School of Business, National College of Ireland, Dublin, Ireland. paul.hanly@ncirl.ie.

ABSTRACT

Background: Radiotherapy provides significant benefits in terms of reducing risk of local recurrence and death from rectal cancer. Despite this, up-to-date cost estimates for radiotherapy are lacking, potentially inhibiting policy and decision-making. Our objective was to generate an up-to-date estimate of the cost of traditional radiotherapy for rectal cancer and model the impact of a range of potential efficiency improvements.

Methods: Microcosting methods were used to estimate total direct radiotherapy costs for long- (assumed at 45-50 Gy in 25 daily fractions over a 5 week period) and short-courses (assumed at 25 Gy in 5 daily fractions over a one week period). Following interviews and on-site visits to radiotherapy departments in two designated cancer centers, a radiotherapy care pathway for a typical rectal cancer patient was developed. Total direct costs were derived by applying fixed and variable unit costs to resource use within each care phase. Costs included labor, capital, consumables and overheads. Sensitivity analyses were performed.

Results: Radiotherapy treatment was estimated to cost between €2,080 (5-fraction course) and €3,609 (25-fraction course) for an average patient in 2012. Costs were highest in the treatment planning phase for the short-course (€1,217; 58% of total costs), but highest in the radiation treatment phase for the long-course (€1,974: 60% of total costs). By simultaneously varying treatment time, capacity utilization rates and linear accelerator staff numbers, the base cost fell by 20% for 5-fractions: (€1,660) and 35% for 25-fractions: (€2,354).

Conclusions: Traditional radiotherapy for rectal cancer is relatively inexpensive. Moreover, significant savings may be achievable through service organization and provision changes. These results suggest that a strong economic argument can be made for expanding the use of radiotherapy in rectal cancer treatment.

No MeSH data available.


Related in: MedlinePlus