ESTRO 38 Abstract book

S316 ESTRO 38

Brussels, Belgium ; 7 Ghent University, Department of Radiation Oncology and Experimental Cancer Research, Ghent, Belgium Purpose or Objective There is a steady rise in the use of Stereotactic Body RadioTherapy (SBRT) in oligometastatic disease (OMD). Besides a positive impact on patients’ outcome, this may generate important financial consequences for radiotherapy budgets. Awaiting more clinical evidence, the Belgian compulsory health insurance system initiated a coverage with evidence development (CED) project for innovative radiotherapy, including SBRT, in 2011. Consequently, a provisional financing to treat OMD with SBRT was available in Belgium from 2013 onwards. While analysis of the clinical and technical data captured between 9-2013 and 12-2017 is ongoing and inclusion in the formal reimbursement system pending, a cost- calculation and budget impact analysis (BIA) was carried out. Material and Methods Using the CED data, the uptake of SBRT in patients with OMD in Belgium between 2013 and 2017 was reviewed. Based on these data, predictive growth scenarios for future uptake were developed. The cost of an SBRT treatment in the OMD setting in Belgium was calculated using the Health Economics in Radiation Oncology Time- Driven Activity-Based Costing (HERO TD-ABC) model developed by ESTRO, alimented with national data on resources, treatments and operational parameters. Combining all this information, the future impact of this novel treatment indication on the radiotherapy budget in Belgium was evaluated. Results The CED data showed a large increase in number of OMD treated with SBRT in Belgium: from 59 in 2013 to 459 in 2017. Based on this, three growth scenarios for uptake were developed: scenario 1, predicting a further linear increase; scenario 2, only accounting for demographic shift; and an ‘intermediate’ scenario 3 with linear increase for two more years, then plateauing to the demographic trends (Figure 1).

Conclusion The possible impact on the radiotherapy budget of uptake of SBRT for OMD shows large variations. These data should be evaluated in the context of improved outcome and set against the background of the actual Belgian radiotherapy budget amounting to roughly 120 million €. Further real- life clinical and financial monitoring and prospective data gathering seems necessary. OC-0602 Pattern of care of radiotherapy practice for EBRT patients in Spain N. Defourny 1 , A.L. Medina 2 , J.L. Tarjuelo 3 , A. Rodríguez 4 , J. Giralt 5 , J.C. Novais 6 , M.M. Martín 7 , A.M. Luis 8 , J. Isern 9 , I.H. Lopez 10 , O. Leaman 11 , F. Arias De la Vega 12 , R. Morera 13 , L. Cerezo 14 , F.L. Campos 15 , S. Rodríguez 16 , A.J. Conde Moreno 17 , A. Lozano Borbalas 18 , N. Rodríguez de Dios 19 , M.E. Rodríguez-Ruiz 20 , P.C. Lara 21 , C. Ferrer 22 , J.M. Borras 23 , C. Grau 24 , Y. Lievens 25 1 ESTRO A.I.S.B.L., HERO, Brussels, Belgium ; 2 Conselleria de Sanidade, Medical Physics and Radiation Protection, Coruña, Spain ; 3 Consorcio Hospitalario Provincial de Castellón, Medical Physics and Radiation Protection, Castelló de la Plana- Spain, Spain ; 4 Hospital Ruber Internacional, Radiation Oncology Department, Madrid, Spain ; 5 Vall d’Hebron University Hospital, Department of Radiation Oncology, Barcelona, Spain ; 6 Hospital Universitario Quirón Madrid, So Radiofísica y Protección Radiológica, Madrid, Spain ; 7 Hospital Universitario de la Princesa, Department of Radiation Oncology-, Madrid, Spain ; 8 Hospital Ramón y Cajal, Department of Radiation Oncology, Madrid, Spain ; 9 Hospital de la Santa Creu i Sant Pau, Radiotherapy, San Pau, Spain ; 10 Hospital Universitari Sant Joan de Reus, S.Oncología Radioterápica, Reus, Spain; 11 Hospital Duran i Reynals, Radiation Oncology Department, Hospitalet de Llobregat, Spain; 12 Hospital de Navarra, Radiotherapeutic Oncology Department, Navarra, Spain ; 13 Clinica La Milagrosa, Tomotherapy Unit, Madrid, Spain ; 14 Hospital de la Princesa, Department of Radiation Oncology, Madrid, Spain ; 15 Fundación Instituto Valenciano de Oncología IVO, Servicio de Oncología Radioterápica, Valencia, Spain ; 16 Benidorm Hospital, Radiotherapy Department, Alicante, Spain ; 17 Instituto Oncológico de Castellón “Dr. Altava”, Servicio de Oncología Radioterápica, Castellón, Spain ; 18 L’Hospitalet de Llobregat, Servicio de Oncología Radioterápica Institut Català d’Oncologia, Barcelona, Spain; 19 Hospital de l’Esperança, Radiation Oncology Department, Barcelona, Spain ; 20 University of Navarra Clinic, Radiation Oncology Department, Pamplona, Spain ; 21 Hospital Universitario de Gran Canaria Dr. Negrín, Radiation Oncology Department, Las Palmas, Spain ; 22 Consorcio Hospitalario Provincial de Castellón, Servicio de Oncología Radioterápica, Castellón, Spain ; 23 L'Hospitalet de Llobregat, Cancer Prevention and Control Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain; 24 Aarhus University Hospital, Department of Oncology-, Aarhus, Denmark; 25 Ghent University Hospital, Department of Radiation Oncology, Ghent, Belgium

Using the HERO TD-ABC model, a real-life cost of 4,359 € per SBRT treatment was calculated, whereas the provisional financing within the CED program amounted to 3,802 €. The 3 growth scenarios and the costs were combined to estimate the impact on the radiotherapy budget. For the TD-ABC costs, all OMD SBRT treatments were considered new indications, hence, additional SBRT courses and costs. For the CED financing data, 2 comparator scenarios were assumed. In the comparator 1 scenario, the SBRT courses for patients treated in the OMD setting are all considered additional SBRT courses. In the comparator 2 scenario, 50% of the SBRT courses are considered new cases and 50% are considered as previously treated with palliative intent, leading to a lower cost increment. Table 1 demonstrates the financial impact of the different scenarios.

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