In Search of the Economic Sustainability of Hadron Therapy: The Real Cost of Setting Up and Operating a Hadron Facility
- Department of Radiotherapy, Ghent University Hospital, Gent (Belgium)
- Department of Radiation Oncology, University Hospital Gasthuisberg, Leuven (Belgium)
- Belgian Hadron Therapy Center Foundation, Brussels (Belgium)
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.
- OSTI ID:
- 22416558
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 89, 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); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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