How costly is particle therapy? Cost analysis of external beam radiotherapy with carbon-ions, protons and photons

Peeters, Andrea; Grutters, Janneke P.C.; Pijls-Johannesma, Madelon; Reimoser, Stefan; De Ruysscher, Dirk; Severens, Johan L.; Joore, Manuela A.; Lambin, Philippe

doi:10.1016/j.radonc.2009.12.002

« Previous Next »Radiotherapy & Oncology
Volume 95, Issue 1 , Pages 45-53, April 2010

How costly is particle therapy? Cost analysis of external beam radiotherapy with carbon-ions, protons and photons

Andrea Peeters
- Maastricht Radiation Oncology (MAASTRO Clinic), The Netherlands
- Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, The Netherlands
Janneke P.C. Grutters
- Maastricht Radiation Oncology (MAASTRO Clinic), The Netherlands
- Department of Health Organization, Policy & Economics, Maastricht University, The Netherlands
Madelon Pijls-Johannesma
- Maastricht Radiation Oncology (MAASTRO Clinic), The Netherlands
- GROW Research Institute, University Medical Center, Maastricht, The Netherlands
- Corresponding author. Address: Maastricht Radiation Oncology (MAASTRO Clinic), Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands.
Stefan Reimoser
- Turner & Townsend, München, Germany
Dirk De Ruysscher
- Maastricht Radiation Oncology (MAASTRO Clinic), The Netherlands
- GROW Research Institute, University Medical Center, Maastricht, The Netherlands
Johan L. Severens
- Department of Health Organization, Policy & Economics, Maastricht University, The Netherlands
- Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, The Netherlands
Manuela A. Joore
- Department of Health Organization, Policy & Economics, Maastricht University, The Netherlands
- Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, The Netherlands
- These authors contributed equally to this work.
Philippe Lambin
- Maastricht Radiation Oncology (MAASTRO Clinic), The Netherlands
- GROW Research Institute, University Medical Center, Maastricht, The Netherlands
- These authors contributed equally to this work.

Received 18 December 2008; received in revised form 8 December 2009; accepted 17 December 2009. published online 27 January 2010.

Abstract

Purpose

Particle therapy has potentially a better therapeutic ratio than photon therapy. However, investment costs are much higher. This study provides an estimation and comparison of the costs of these therapies.

Methods

Within an extensive analytical framework capital and operational costs, cost per fraction, and four tumor specific treatment costs are calculated for three facilities: combined carbon-ion/proton, proton-only, and photon.

Results

Capital costs for the combined, proton-only and photon facilities are: € 138.6 million, € 94.9 million, € 23.4 million. Total costs per year are: € 36.7 million, € 24.9 million, € 9.6 million. Cost per fraction is: € 1128 (€ 877–1974), € 743 (€ 578–1300), € 233 (€ 190–407). Cost ratio particle/photon therapy is 4.8 for the combined and 3.2 for the proton-only facility. Particle treatment costs vary from € 10,030 (c-ion: lung cancer) to € 39,610 (proton: head & neck tumors). Cost difference between particle and photon therapies is relatively small for lung and prostate cancer, larger for skull-base chordoma and head & neck tumors.

Conclusion

Investment costs are highest for the combined carbon-ion/proton facility and lowest for the photon facility. Cost differences become smaller when total costs per year and specific treatment costs are compared. Lower fractionation schedule of particle therapy might further reduce its costs.

Keywords: Particle therapy, Cost, Cost-effectiveness, Photon, C-ion, Hadron