The Swedish Council on technology Assessment in Healthcare Radiotherapy for Cancer. Chapter 8.
Acta Oncológica 1997 (35) Spul 6
Páginas: 57-71 pág.
This chapter addresses the economic aspects of radiotherapy. It includes a summary of the costs for radiotherapy in Sweden, a literature review of economic studies on cancer radiotherapy, and estimates of radiotherapy costs in Sweden for 1991. Appendix I describes the types of economic assessments relevant to an economic analysis of radiotherapy. Appendix II analyzes potential economies of scale, and the economic consequences of changed fractionation schedules. Cancer diagnosis and treatment accounts for approximately 5% of the total healthcare expenditure in Sweden (1), corresponding to 6.9 billion Swedish kronor (SEK) per year in 1993 monetary value. The costs of radiotherapy, an important modality for treating cancer, have not been fully described. This report presents such an estimate. The cost of external radiotherapy in Sweden in 1991 was approximately 260 million SEK. This corresponds to approximately 4% of the cost for cancer care. On average, the cost per irradiated field was approximately 500 SEK, the cost per fraction approximately 1125 SEK, and the cost per patient approximately 17,200 SEK. The estimates per patient vary widely by group. A rough estimate of the cost for curative radiotherapy for breast cancer would be approximately 31,000 SEK, which can be contrasted with a cost of approximately 7000 SEK for palliative treatment of bone metastases. The cost for brachytherapy in 1991 was, according to departmental financial reports, approximately 36 million SEK. Hence, the costs for external radiotherapy and brachytherapy were approximately 300 million SEK in 1991. In 1993 prices, this corresponds to approximately 330 million SEK, representing the total direct costs for radiotherapy in Sweden. However, this figure does not include costs for, eg, hospitalization in conjunction with radiotherapy, nor the other costs associated with this type of treatment. Several potential sources of error underlie these figures. The following overview presents and evaluates the foundation for these estimates. Appendix I to this chapter discusses the problem of how these estimates should be defined, and how costs should be related to the different ways for measuring treatment results.