Challenges in assessing national radiotherapy costs: application of the ESTRO-HERO model in Spain

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• dc.contributor.author Corral, Julieta
• dc.contributor.author Algara López, Manuel-Ignacio
• dc.contributor.author Muñoz Montplet, Carles
• dc.contributor.author Eraso, Arantxa
• dc.contributor.author Giralt, Jordi
• dc.contributor.author Defourny, Noémie
• dc.contributor.author Lievens, Yolande
• dc.contributor.author Borràs, Josep M.
• dc.date.accessioned 2025-02-21T07:13:34Z
• dc.date.available 2025-02-21T07:13:34Z
• dc.date.issued 2024
• dc.description.abstract Background and purpose: The aim was to estimate the cost of the external beam radiotherapy (EBRT) in public health care centers in Catalonia (Spain), according to the ESTRO-HERO costing model for 2018. Materials and methods: Personnel, equipment, and activity data from 2018 from the 11 RT centers were used, incorporating European mean values adapted to the Catalan context. Secondly, EBRT costs were estimated, incorporating 2023 fractionation technique and scheme usage percentages. Finally, complementary estimates were included: complementary planning examinations, stereotactic body radiation therapy (SBRT) fiducial markers, and hospital overhead costs. Results: In 2018, EBRT cost was estimated at EUR 42.2 M for all patients in the region. Directly related treatment activities represented 69.0% of the total cost, while support and non-directly related EBRT activities accounted for 20.2 and 10.8%, respectively. Mean radical treatment cost varied from €1714 (leukemia) to €4,645 (pancreas), and for palliative intent, from €938 (bone metastases) to €1753 (brain metastases). According to the technique used, costs ranged from €1,475 (3D conformal) to €3,608 (rotational IMRT), and by fractionation scheme, from €1,308 (extreme hypofractionation) to €4,094 (standard fractionation). Accounting for 2023 complexity levels, mean treatment cost rose by 0.9%, but varied widely by tumor site, with a 13% increase for stomach cancer, and decreases of -15.0, -24.4, and - 17.2% in myeloma, pancreas, and lung cancer, respectively. Including complementary examinations and hospital overhead costs, mean cost increased by 15.6%. Conclusion: This study provides a first approximation to EBRT cost using time-driven activity-based costing (TD-ABC) in Catalonia showing the feasibility of the assessment. For each indication, average treatment cost increases with the associated complexity. Additionally, costs decrease with hypofractionation schemes, largely due to lower equipment weight in treatment cost. Consequently, the adoption of stereotactic techniques is driving cost decreases. Overall, this model represents a robust tool for analyzing different possible scenarios, including changes in fractionation and complexity.
• dc.format.mimetype application/pdf
• dc.identifier.citation Corral J, Algara M, Muñoz-Montplet C, Eraso A, Giralt J, Defourny N, et al. Challenges in assessing national radiotherapy costs: application of the ESTRO-HERO model in Spain. Front Public Health. 2024 Dec 19;12:1474376. DOI: 10.3389/fpubh.2024.1474376
• dc.identifier.doi http://dx.doi.org/10.3389/fpubh.2024.1474376
• dc.identifier.issn 2296-2565
• dc.identifier.uri http://hdl.handle.net/10230/69667
• dc.language.iso eng
• dc.publisher Frontiers
• dc.relation.ispartof Front Public Health. 2024 Dec 19;12:1474376
• dc.rights © 2024 Corral, Algara, Muñoz-Montplet, Eraso, Giralt, Defourny, Lievens and Borras. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Costing model
• dc.subject.keyword Economic evaluation
• dc.subject.keyword External beam radiotherapy
• dc.subject.keyword Time-driven activity based costing (TD-ABC)
• dc.subject.keyword Value-based healthcare
• dc.title Challenges in assessing national radiotherapy costs: application of the ESTRO-HERO model in Spain
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion