Cost Analysis of Selected Radiotherapeutic Modalities for Prostate Cancer Treatment-Czech Republic Case Study for the Purposes of Hospital Based HTA.

Petra Hospodková,Roman Svoboda,Lucie Severová,Barbora Klíčová,Karel Šrédl,Tomáš Husár

doi:10.3390/healthcare9010098

Abstract

This study aims to calculate the costs of prostate cancer radiotherapy in a regional hospital Department of Radiation Oncology equipped with Three-Dimensional Conformal Radiation Therapy (3D-CRT) and Intensity Modulated Radiation Therapy (IMRT) Volumetric Arc Therapy (VMAT) radiation technology, using activity based costing (ABC), and to compare the costs of both methods at the level of component treatment process activities and with respect to insurance reimbursements. The costing was performed based on a sample of 273 IMRT VMAT patients and 312 3D-CRT patients in a regional hospital in the period from 2018 to 2019. The research has highlighted the necessity to place emphasis on factors that may skew the costing results. The resulting output has been supplemented by a sensitivity analysis, whereas the modeled parameter is represented by the time required for one patient fraction on a linear accelerator and the time the Radiology Assistant needs to prepare the complete radiation plan as part of radiotherapy planning. Moreover, the effects of the received grant, in the form of calculated write-offs, are also considered. The case study uses the example of radiotherapy to demonstrate the potential of ABC and suggests considering the application of this method as an effective management tool for cost and economic evaluation as part of comprehensive hospital assessment under the Hospital-Based Health Technology Assessment (HB-HTA) initiative.

Highlights

This study aims to determine the costs of prostate cancer radiotherapy in a regional hospital Department of Radiation Oncology equipped with 3D-CRT and Volumetric Arc Therapy (VMAT) radiation technology, using the activity based costing (ABC) method with a view to comparing the costs of both methods in general and with respect to insurance reimbursements
Identification of Costs Included in the Calculation
Intensity Modulated Radiation Therapy (IMRT) appears to be the less expensive technology of the two addressed in this case study

Summary

Introduction

A growing interest in Hospital-Based Health Technology Assessment (HBHTA) methods has been observed, since it can provide important support for decisionmaking in the area of purchasing, implementation and/or disinvestment of technologies or interventions in hospitals [1,2]. In modern competitive reimbursement environments, providers and policy makers are looking for cost-accounting solutions capable of informing process improvement and meeting the expectations of cost-control policies [3]. Ritrovato et al [4] claim that HB-HTA is able to guarantee that all hospital economic, instrumental and human resources will be used and allocated with efficacy, efficiency, and economic criteria, ensuring high quality healthcare assistance. HB-HTA is considered to be a useful tool that facilitates faster and earlier decision-making and improves the effectiveness of accepted healthcare technologies at the hospital level, as well as patient safety

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Discussion

Conclusion