Costes de los servicios sanitarios asociados al tratamiento del cáncer de mama precoz con radioterapia adyuvante

Abstract

ObjectiveTo assess the healthcare costs associated with six radiation therapy (RT) techniques for the adjuvant treatment of early breast cancer. MethodsA team of six radiation oncologists and a specialist in health economics performed a descriptive cost analysis among the following RT techniques: 3-dimensional conformal RT (3DCRT) using either conventional fractionation (2Gy/fraction) or hypofractionation (2,6Gy/fraction), partial-breast irradiation (PBI) delivered with the use of 3DCRT or brachytherapy (high and low dose rate), and intraoperative RT (IORT). Treatment costs included hospitalization, medical (simulation, contouring, and verification and approval of treatment plans) and nursing consults, radiological examinations, and dosimetry calculation. Costs were obtained from the last update of public prices in the Andalusian Public Health System, updated to 2013. ResultsThe treatment cost for conventional fractionation with 3DCRT was 6,786.75€, whereas the cost of the hypofractionated regimen using the same technology was 4,998.17€. PBI costs were 4,066.10€, 4,797.35€, 4,376.97€ and 7,715.43€ for 3DCRT, low-dose rate brachytherapy, high-dose rate brachytherapy, and IORT, respectively. ConclusionsThere is wide cost variation among RT techniques for the adjuvant treatment of early breast cancer. The technique with the lowest healthcare cost is PBI through 3DCRT. Official government prices should be updated and should also include the new technologies incorporated in recent years.