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Title: In Search of the Economic Sustainability of Hadron Therapy: The Real Cost of Setting Up and Operating a Hadron Facility

Abstract

Purpose: To determine the treatment cost and required reimbursement for a new hadron therapy facility, considering different technical solutions and financing methods. Methods and Materials: The 3 technical solutions analyzed are a carbon only (COC), proton only (POC), and combined (CC) center, each operating 2 treatment rooms and assumed to function at full capacity. A business model defines the required reimbursement and analyzes the financial implications of setting up a facility over time; activity-based costing (ABC) calculates the treatment costs per type of patient for a center in a steady state of operation. Both models compare a private, full-cost approach with public sponsoring, only taking into account operational costs. Results: Yearly operational costs range between €10.0M (M = million) for a publicly sponsored POC to €24.8M for a CC with private financing. Disregarding inflation, the average treatment cost calculated with ABC (COC: €29,450; POC: €46,342; CC: €46,443 for private financing; respectively €16,059, €28,296, and €23,956 for public sponsoring) is slightly lower than the required reimbursement based on the business model (between €51,200 in a privately funded POC and €18,400 in COC with public sponsoring). Reimbursement for privately financed centers is very sensitive to a delay in commissioning and to themore » interest rate. Higher throughput and hypofractionation have a positive impact on the treatment costs. Conclusions: Both calculation methods are valid and complementary. The financially most attractive option of a publicly sponsored COC should be balanced to the clinical necessities and the sociopolitical context.« less

Authors:
 [1];  [2];  [3]; ;  [1]
  1. Department of Radiotherapy, Ghent University Hospital, Gent (Belgium)
  2. Department of Radiation Oncology, University Hospital Gasthuisberg, Leuven (Belgium)
  3. Belgian Hadron Therapy Center Foundation, Brussels (Belgium)
Publication Date:
OSTI Identifier:
22416558
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 89; Journal Issue: 1; Other Information: Copyright (c) 2014 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; COMMISSIONING; COMPARATIVE EVALUATIONS; COST RECOVERY; FINANCING; FRACTIONATED IRRADIATION; HEAVY IONS; ION BEAMS; OPERATING COST; PATIENTS; RADIOTHERAPY; SUSTAINABILITY

Citation Formats

Vanderstraeten, Barbara, Verstraete, Jan, De Croock, Roger, De Neve, Wilfried, and Lievens, Yolande. In Search of the Economic Sustainability of Hadron Therapy: The Real Cost of Setting Up and Operating a Hadron Facility. United States: N. p., 2014. Web. doi:10.1016/J.IJROBP.2014.01.039.
Vanderstraeten, Barbara, Verstraete, Jan, De Croock, Roger, De Neve, Wilfried, & Lievens, Yolande. In Search of the Economic Sustainability of Hadron Therapy: The Real Cost of Setting Up and Operating a Hadron Facility. United States. https://doi.org/10.1016/J.IJROBP.2014.01.039
Vanderstraeten, Barbara, Verstraete, Jan, De Croock, Roger, De Neve, Wilfried, and Lievens, Yolande. 2014. "In Search of the Economic Sustainability of Hadron Therapy: The Real Cost of Setting Up and Operating a Hadron Facility". United States. https://doi.org/10.1016/J.IJROBP.2014.01.039.
@article{osti_22416558,
title = {In Search of the Economic Sustainability of Hadron Therapy: The Real Cost of Setting Up and Operating a Hadron Facility},
author = {Vanderstraeten, Barbara and Verstraete, Jan and De Croock, Roger and De Neve, Wilfried and Lievens, Yolande},
abstractNote = {Purpose: To determine the treatment cost and required reimbursement for a new hadron therapy facility, considering different technical solutions and financing methods. Methods and Materials: The 3 technical solutions analyzed are a carbon only (COC), proton only (POC), and combined (CC) center, each operating 2 treatment rooms and assumed to function at full capacity. A business model defines the required reimbursement and analyzes the financial implications of setting up a facility over time; activity-based costing (ABC) calculates the treatment costs per type of patient for a center in a steady state of operation. Both models compare a private, full-cost approach with public sponsoring, only taking into account operational costs. Results: Yearly operational costs range between €10.0M (M = million) for a publicly sponsored POC to €24.8M for a CC with private financing. Disregarding inflation, the average treatment cost calculated with ABC (COC: €29,450; POC: €46,342; CC: €46,443 for private financing; respectively €16,059, €28,296, and €23,956 for public sponsoring) is slightly lower than the required reimbursement based on the business model (between €51,200 in a privately funded POC and €18,400 in COC with public sponsoring). Reimbursement for privately financed centers is very sensitive to a delay in commissioning and to the interest rate. Higher throughput and hypofractionation have a positive impact on the treatment costs. Conclusions: Both calculation methods are valid and complementary. The financially most attractive option of a publicly sponsored COC should be balanced to the clinical necessities and the sociopolitical context.},
doi = {10.1016/J.IJROBP.2014.01.039},
url = {https://www.osti.gov/biblio/22416558}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 89,
place = {United States},
year = {Thu May 01 00:00:00 EDT 2014},
month = {Thu May 01 00:00:00 EDT 2014}
}