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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

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
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; 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)
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