Vikneswary Batumalai1, Karen Wong2, Jesmin Shafiq3, Timothy P Hanna4, Gabriel Gabriel3, Julia Heberle5, Ivan Koprivic5, Nasreen Kaadan6, Odette King7, Thomas Tran7, Lynette Cassapi8, Dion Forstner9, Geoff P Delaney2, Michael Barton2. 1. Department of Radiation Oncology, South Western Sydney Local Health District, Australia; Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, Australia; South Western Clinical School, University of New South Wales, Australia. Electronic address: vikneswary.batumalai@health.nsw.gov.au. 2. Department of Radiation Oncology, South Western Sydney Local Health District, Australia; Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, Australia; South Western Clinical School, University of New South Wales, Australia. 3. Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, Australia; South Western Clinical School, University of New South Wales, Australia. 4. Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, Australia; Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Canada. 5. Activity Based Management, New South Wales Health, Australia. 6. Department of Radiation Oncology, South Western Sydney Local Health District, Australia; Sydney and South West Sydney Clinical Cancer Registry, Ingham Institute for Applied Medical Research, Australia. 7. Department of Radiation Oncology, South Western Sydney Local Health District, Australia. 8. Department of Radiation Oncology, Calvary Mater Newcastle, Australia. 9. Department of Radiation Oncology, South Western Sydney Local Health District, Australia; Genesis Care Radiation Oncology, St Vincent's Hospital Sydney, Australia; School of Medicine, Western Sydney University, Australia.
Abstract
BACKGROUND AND PURPOSE: Escalating health care costs have led to greater efforts directed at measuring the cost and benefits of medical treatments. The aim of this study was to estimate the costs of 5-year local control and overall survival benefits of radiotherapy for the cancer population in Australia. MATERIALS AND METHODS: The local control and overall survival benefits of radiotherapy at 5-years and optimal number of fractions per course have been estimated for 26 tumour sites for which radiotherapy is indicated. For this study, a hybrid approach that merges features from activity based costing (ABC) and relative value units costing (RVU) were used to provide cost estimates. ABC methodology was used to allocate costs to all radiotherapy activities associated with each patient's treatment course, while the RVUs represent the cost of each radiotherapy activity relative to the average cost of all activities and were used to achieve a weighted cost allocation. A patient's journey for the financial year was constructed by consolidating all the radiotherapy activities and their associated costs, and the average cost per activity (fraction) was determined. The cost of radiotherapy per 5-year overall survival and local control was then estimated. RESULTS: The estimated population 5-year local control and overall survival benefits of radiotherapy for all cancer were 23% and 6%, respectively. The optimal number of fractions per treatment course if guidelines were followed was 19.4 fractions. The average cost per fraction for all cancer was AU$276. The estimated cost of radiotherapy was AU$23,585 per 5-year local control and AU$86,480 per 5-year overall survival (equivalent to 5 life years) for all cancer. CONCLUSION: The cost of AU$86,480 per 5-year overall survival would translate to AU$17,296 1-year overall survival. Therefore, the cost of radiotherapy is inexpensive if delivered optimally. Policy implications from this study include knowledge about cost to deliver radiotherapy to allow one to quantify the expected benefit at a population level. Crown
BACKGROUND AND PURPOSE: Escalating health care costs have led to greater efforts directed at measuring the cost and benefits of medical treatments. The aim of this study was to estimate the costs of 5-year local control and overall survival benefits of radiotherapy for the cancer population in Australia. MATERIALS AND METHODS: The local control and overall survival benefits of radiotherapy at 5-years and optimal number of fractions per course have been estimated for 26 tumour sites for which radiotherapy is indicated. For this study, a hybrid approach that merges features from activity based costing (ABC) and relative value units costing (RVU) were used to provide cost estimates. ABC methodology was used to allocate costs to all radiotherapy activities associated with each patient's treatment course, while the RVUs represent the cost of each radiotherapy activity relative to the average cost of all activities and were used to achieve a weighted cost allocation. A patient's journey for the financial year was constructed by consolidating all the radiotherapy activities and their associated costs, and the average cost per activity (fraction) was determined. The cost of radiotherapy per 5-year overall survival and local control was then estimated. RESULTS: The estimated population 5-year local control and overall survival benefits of radiotherapy for all cancer were 23% and 6%, respectively. The optimal number of fractions per treatment course if guidelines were followed was 19.4 fractions. The average cost per fraction for all cancer was AU$276. The estimated cost of radiotherapy was AU$23,585 per 5-year local control and AU$86,480 per 5-year overall survival (equivalent to 5 life years) for all cancer. CONCLUSION: The cost of AU$86,480 per 5-year overall survival would translate to AU$17,296 1-year overall survival. Therefore, the cost of radiotherapy is inexpensive if delivered optimally. Policy implications from this study include knowledge about cost to deliver radiotherapy to allow one to quantify the expected benefit at a population level. Crown
Authors: Paul J Keall; Caterina Brighi; Carri Glide-Hurst; Gary Liney; Paul Z Y Liu; Suzanne Lydiard; Chiara Paganelli; Trang Pham; Shanshan Shan; Alison C Tree; Uulke A van der Heide; David E J Waddington; Brendan Whelan Journal: Nat Rev Clin Oncol Date: 2022-04-19 Impact factor: 65.011