ESTRO 2025 - Abstract Book

S2287

Interdisciplinary – Health economics & health services research

ESTRO 2025

Results: Table 1 provides an overview of the shortcomings identified, their impact on the model’s results, the underlying causes and proposed solutions. Five major shortcomings were identified and addressed: (1) Time estimations, previously based on technique, now consider tumor site to better align with the critical factors of the care pathway. (2) Treatment machines are specified individually and linked to treatments by the user, with innovation costs allocated accordingly to treatment cost. (3) Equipment operation time, previously fixed to personnel capacity, is now adjustable, enabling sensitivity analysis of daily operating hours for each machine. (4) Both online and offline adaptive strategies are integrated into the care pathway: an “online planning” activity is added, while offline strategies repeat care pathway activities from simulation to treatment. The number of adaptive fractions can be defined. (5) Oligometastatic indication is clarified through distinct categorization of radical vs. non radical interventions, and primary vs. metastatic tumors. These upgrades are highlighted in the yellow boxes of the model’s structure (Figure 1).

Conclusion: The upgraded ESTRO-HERO cost model addresses user-identified shortcomings by aligning with current advancements in radiation oncology, including new indications like oligometastatic disease and techniques such as adaptive radiotherapy. The beta-version offers a more realistic and future-proof model, enabling better resource planning and informed decision-making at the healthcare provider and national level. Future work will focus on integrating uncertainties, and validating the model in real-world settings.

Keywords: innovation, cost accounting, resource prediction

References: [1] Defourny, Noemie et al. “National costs and resource requirements of external beam radiotherapy: A time driven activity-based costing model from the ESTRO-HERO project.” Radiotherapy and Oncology 138 (2019): 187 - 194.