The cost of radiotherapy as a function of facility size and hours of operation.

Against a background of constant or decreasing budgets, this study was undertaken to investigate the economic effects of changes in selected operational parameters within a radiation treatment programme. Using financial data from the Northeastern Ontario Regional Cancer Centre and a recognized staffing model, a commercial spreadsheet has been used to calculate the cost of an 18 fraction course of radiotherapy, including all the major preparatory processes such as simulation and treatment planning. Using the spreadsheet, and on the basis of explicit and reasonable assumptions, the cost of radiotherapy has been calculated as the facility size (i.e. equipment complement) and hours of operation are varied. Based on the assumptions used, the cost of radiotherapy in a facility treating less than about 1600 patients per year starts to rise. At 400 patients per year, a course costs approximately 50% more than at 1600 patients per annum. Extended hours of operation do not appear to generate significant, if any, savings when realistic assumptions about machine lifetime and overtime payments are made. Using a spreadsheet to simulate changes in a radiation treatment programme can be an important decision-making tool, as the effects of changes in operating parameters can be demonstrated.