ESTRO 2022 - Abstract Book

S811

Abstract book

ESTRO 2022

Conclusion A clear dose-response relation for LF and regional plus distant metastatic failure was observed, suggesting that adequate focal dose escalation to the intraprostatic lesions prevents undertreatment of the primary tumor, resulting in a decreased regional and distant metastatic failure rate.

Proffered Papers: Health economics

OC-0919 National costs & resource requirements of radiotherapy: costing estimate from the ESTRO-HERO project

T. Roques 1 , K. Spencer 2 , N. Defourny 3 , P. Diez 4 , A. Francis 5 , S. Griffin 6 , K. Langmack 7 , N. Kirkby 3 , T. Mee 3 , C. Roe 8

1 Royal College of Radiologists, Faculty of Clinical Oncology , London, United Kingdom; 2 University of Leeds, Academic Unit of Health Economics, Leeds, United Kingdom; 3 University of Manchester, School of Medical Sciences, Manchester, United Kingdom; 4 National Radiotherapy Trials Quality Assurance Group, Mount Vernon Cancer Centre, Radiotherapy Physics, Northwood, United Kingdom; 5 Guy's and St Thomas' NHS Foundation Trust, Radiotherapy, London, United Kingdom; 6 Royal College of Radiologists, Faculty of Clinical Oncology, London, United Kingdom; 7 Nottingham University Hospitals NHS Trust, Radiotherapy Physics, Nottingham, United Kingdom; 8 NHS Digital, National Radiotherapy Dataset, London, United Kingdom Purpose or Objective To estimate the cost of external beam radiotherapy in England in 2017 using a time-driven activity-based costing method Materials and Methods The ESTRO-HERO model was populated with data from England in 2017 by a multi-professional team from seven radiotherapy centres. The number of courses and fractions for each indication was extracted from the national radiotherapy dataset with accurate data from each of the 52 English centres. Personnel numbers were taken from national censuses for each profession. Optional steps (motion management, immobilisation etc) were aggregated from at least 5 radiotherapy centres of different sizes. The time taken for tasks as part of RT preparation, planning and treatment were estimated based on data from two centres revised in consensus with the team. Personnel, equipment and infrastructure costs were obtained from publicly available and internal National Health Service (NHS) sources where available or consensus of the team. Sensitivity analyses were carried out where estimates were particularly uncertain. Results The total cost for radiotherapy in England was € 680m. Of this, 67.3% was core costs of radiotherapy based on time and activity data, the largest component of which was the cost of treatment machines. 21.9% was supporting costs necessary to run a department (eg QA systems) and 10.8% was activities performed by radiotherapy personnel within the multidisciplinary oncology team such as attending tumour board meetings. The average cost of a course of radiotherapy was € 4092. HERO estimates for costs of different treatments were usually slightly higher than reimbursement departments currently receive via the NHS tariff system.

Conclusion Radiotherapy is a relatively small part of the total NHS cancer budget (estimated to be approx. € 7.1bn). These cost estimates can now be used to support analyses of cost-effectiveness, help refine the NHS reimbursement process and inform government investment decisions regarding both equipment and personnel. That treatment machine costs are such a high proportion of the total would support a national linac replacement programme with central procurement whilst the significant impact of bunker costs necessitates careful consideration of the mechanism of future capital funding. By combining these data with estimates of future cancer incidence, this model will also help future workforce modelling recognising the resource implications of changing demand, new fractionation patterns and evolving techniques.

OC-0920 Health-economics and evidence-based hypofractionation uptake in Europe: GIRO-HERO cluster analysis

J. Corral 1 , C. Oliveira 2 , R. Clèries 1 , D. Rodin 3 , J.M. Borras 4 , Y. Lievens 5

1 Department of Health, Generalitat de Catalunya, Catalan Cancer Plan - IDIBELL, Barcelona, Spain; 2 Cancer Center of Southeastern Canada, Department of Oncology, KIngston, Canada; 3 Princess Margaret Cancer Centre Toronto, Radiation