ESTRO Annual Report 2019

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3. Health Economics in Radiation Oncology (HERO)

The HERO cost accounting model and its use In 2019, several countries continued the exercise of using the HERO cost accounting tool, in order to gain insight on national resource requirements and costs of external beam radiotherapy. The dialogue with and the engagement of the national societies is of paramount importance to ensure that the HERO tool is a valuable support in decision making processes and negotiation. We describe the progress of the collaborating countries while more countries are showing interest in themodel and setting up task forces looking into the data collection. Belgium : an interdisciplinary group representing the Belgian national societies collected all the necessary input data to fill in the HERO model and reviewed two rounds of data output. Final model results were presented at the Annual meeting of the Belgian Society of Radiotherapy (BESTRO). Hungary : the implementation strategy of the model was presented at the Annual meeting of the Hungarian Society of Radiotherapy (HUSRO). A team of experts is finishing to validate the estimated outcomes Spain : in order to collect data input to fill in the HERO model, the Spanish radiation oncology community surveyed the patterns of care thanks to a large dedicated survey amongst SEOR tumour site-committees. The results of the survey, providing an overview of patterns of care, were presented at ESTRO 38 in Milan. France : the French national societies undertook a bottom-up input data collection applying the HERO tool in a representative sample of institutes fromeach of the three-hospital types (public, private and non-profit). The seven centers undertaking the tool application are now at different stages: some finalising the data collection and some validating them. United Kingdom : completing available national data sources, a multidisciplinary task force is now collecting remaining data inputs before starting the validation of the model results.

The focus on reimbursement systems Thanks to the collaboration of the HERO group and the National Societies, validating the data collected through a European survey on reimbursement system, an article providing a viewon the EU reimbursement systems have been published: “How public health services pay for radiotherapy in Europe: an ESTRO-HERO analysis of reimbursement”. This Policy Review assesses publicly funded radiotherapy reimbursement systems in Europe, looking also into the annual expenditure covering radiotherapy, calling for enhanced dialogue amongst scientific societies and policy makers, allowing radiation oncology services to follow evolving evidence. Yolande Lievens, Noémie Defourny, Julieta Corral, Chiara Gasparotto, Cai Grau, Josep Maria Borras, and ESTRO–HERO Consortium. How public health services pay for radiotherapy in Europe: an ESTRO–HERO analysis of reimbursement. The Lancet Oncology, Volume 21, Issue 1, 2020 , e42-e54. DOI: 10.1016/S1470- 2045(19)30794-6. Publications In the frame of the HERO project, the PhD investigating especially the cost of radiotherapy has been concluded. The PhD, “Radiotherapy in Europe: cost-modelling at national level”, starting with a state- of the art of the health economics of radiotherapy literature, describes the methodology of the Time-driven Activity- Based Costing (TD-ABC) modelling at national level for radiotherapy (also known as the ESTRO-HERO Tool) alongside with a practical application and discuss its public policies implications. Additional publications: Defourny N, Perrier L, Borras JM, Coffey M, Corral J, Hoozee S, van Loon J, Grau C, Lievens Y. National costs and resource requirements of external beam radiotherapy: a Time-Driven Activity-Based Costing model from the ESTRO- HERO project. Radiother Oncol 2019, 138(1) 187-194. DOI:10.1016/j.radonc.2019.06.015 Defourny N, Monten C, Perrier L, et al. Critical review and quality assessment of cost analyses in radiotherapy: how reliable are the data?

Science & Dissemination

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