ESTRO 2021 Abstract Book
1 Department of Health, Generalitat de Catalunya, Catalan Cancer Strategy, Barcelona, Spain; 2 Parc de Salut MAR, Radiation Oncology Department, Barcelona, Spain; 3 Catalan Institute of Oncology - Girona, Medical Physics and Radiation Protection, Girona, Spain; 4 Catalan Institute of Oncology - Girona, Radiation Oncology Department, Girona, Spain; 5 Vall d'Hebron Barcelona Hospital Campus, Radiation Oncology Department, Barcelona, Spain; 6 Departament of Health, Generalitat de Catalunya, Catalan Cancer Strategy, Barcelona, Spain; 7 University of Manchester, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester, United Kingdom; 8 Ghent University Hospital, Ghent University, Radiation Oncology Department, Ghent, Belgium; 9 University of Barcelona, Department of Clinical Sciences, Barcelona, Spain Purpose or Objective To estimate the cost of external beam radiotherapy (EBRT) in Catalonia (Spain) using the costing model developed by the ESTRO-HERO project (Health Economics in Radiation Oncology - European Society for Radiotherapy and Oncology) for the year 2018. Materials and Methods We implemented the ESTRO-HERO costing model to the autonomous community/region of Catalonia (7.8 million inhabitants). The ESTRO-HERO costing model is based on time-driven activity-based costing (TDABC) and is structured in three layers. The central layer, EBRT-Core, accounts for EBRT care pathway activities and follows TDABC allocation principles. Activities supporting radiation oncology (RO-Support) and multidisciplinary oncology (Beyond-EBRT) follow standard allocation principles. For its application in Catalonia, data from this autonomous community for the year 2018 was used about the number of departments, staff, equipment, and data on the number of cases treated according to tumor location, intention to treat (curative / palliative), fractionation scheme and technique. These data were completed with a set of data defined for a hypothetical country 'Europalia' (including European average data) which were validated for the Catalan context by a group of experts. These data entails time of each EBRT-Core activity, as well as the share of time spent on RO-Support and Beyond-EBRT duties by various personnel task groups). Results The total cost of EBRT treatment across Catalonia was estimated at € 41.5 million, for a total of 14,138 EBRT treatments delivered. The operation was carried out on 36 linear accelerators (1 dedicated stereotactic unit), and by 146, 35, 29, 69 and 128 RO professionals representing the clinical, physics, imaging, planning , and treatment task groups. Activities directly related to the administration of treatment activities (defined in the EBRT care-pathway, EBRT-Core ) represented 71% of the total cost, while support activities ( RO-Support ) and those not directly related ( Beyond-EBRT ) represented 17% and 12% of the total. The overall average cost of a treatment varies between € 3,394 for curative and € 1,339 for palliative intent, between € 1,847 (leukaemia) and € 4,589 (pancreas) according to the different indications, between € 1,589 (3D conformal) and € 3,446 (rotational IMRT) depending on the technique used, and between € 1,382 (extreme hypofractionation) and € 3,967 (standard fractionation) based on the treatment scheme (Table 1).
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