Aim: The aim of this study was to estimate the costs of 5-year local control and overall survival benefits of radiotherapy for the cancer population in Australia.
Methods: The local control and overall survival benefits of radiotherapy at 5-years and optimal number of fractions per course have been estimated for 26 tumour sites for which radiotherapy is indicated. A hybrid approach that merges features from activity based costing (ABC) and relative value units costing (RVU) was used to provide cost estimates. ABC methodology was used to allocate costs to all radiotherapy activities associated with each patient’s treatment course, while the RVUs represent the cost of each radiotherapy activity relative to the average cost of all activities and were used to achieve a weighted cost allocation. All radiotherapy activities (pre-treatment, treatment and post-treatment) associated with each tumour site and the associated cost was consolidated together, and the average cost per activity (fraction) was determined. The cost of radiotherapy per 5-year overall survival and local control was then estimated.
Results: The estimated population 5-year local control and overall survival benefits of radiotherapy for all cancer were 23% and 6%, respectively. The optimal number of fractions per treatment course if guidelines were followed was 19.4 fractions. The average cost per fraction for all cancer was AU$276. The estimated cost of radiotherapy was AU$23,585 per 5-yeal local control and AU$86,480 per 5-year overall survival (equivalent to 5 life years) for all cancer.
Conclusions: The cost of AU$86,480 per 5-year overall survival would translate to AU$17,296 per life year gained. Therefore, the cost of radiotherapy is inexpensive if delivered optimally. Policy implications from this study include knowledge about cost to deliver radiotherapy to allow one to quantify the expected benefit at a population level.