Radiation costing methods: a systematic review

  • F. Rahman Institute for Clinical Evaluative Sciences
  • S.J. Seung Sunnybrook Research Institute
  • S.Y. Cheng Institute for Clinical Evaluative Sciences
  • H. Saherawala Sunnybrook Research Institute
  • C.C. Earle Institute for Clinical Evaluative Sciences
  • N. Mittmann Cancer Care Ontario; University of Toronto; Sunnybrook Research Institute
Keywords: Radiation therapy, costs, cost analyses, cost-effectiveness analyses, cost–benefit analyses

Abstract

Objective

Costs for radiation therapy (rt) and the methods used to cost rt are highly diverse across the literature. To date, no study has compared various costing methods in detail. Our objective was to perform a thorough review of the radiation costing literature to identify sources of costs and methods used.

Methods

A systematic review of Ovid medline, Ovid oldmedline, embase, Ovid HealthStar, and EconLit from 2005 to 23 March 2015 used search terms such as “radiation,” “radiotherapy,” “neoplasm,” “cost,” “ cost analysis,” and “cost benefit analysis” to locate relevant articles. Original papers were reviewed for detailed costing methods. Cost sources and methods were extracted for papers investigating rt modalities, including three-dimensional conformal rt (3D-crt), intensity-modulated rt (imrt), stereotactic body rt (sbrt), and brachytherapy (bt). All costs were translated into 2014 U.S. dollars.

Results

Most of the studies (91%) reported in the 33 articles retrieved provided rt costs from the health system perspective. The cost of rt ranged from US$2,687.87 to US$111,900.60 per treatment for imrt, followed by US$5,583.28 to US$90,055 for 3D-crt, US$10,544.22 to US$78,667.40 for bt, and US$6,520.58 to US$19,602.68 for sbrt. Cost drivers were professional or personnel costs and the cost of rt treatment. Most studies did not address the cost of rt equipment (85%) and institutional or facility costs (66%).

Conclusions

Costing methods and sources were widely variable across studies, highlighting the need for consistency in the reporting of rt costs. More work to promote comparability and consistency across studies is needed.

Author Biographies

S.J. Seung, Sunnybrook Research Institute

Health Outcomes and Pharmacoeconomics (hope) Research Centre

H. Saherawala, Sunnybrook Research Institute

Health Outcomes and Pharmacoeconomics (hope) Research Centre

Published
2016-08-08
How to Cite
Rahman, F., Seung, S., Cheng, S., Saherawala, H., Earle, C., & Mittmann, N. (2016). Radiation costing methods: a systematic review. Current Oncology, 23(4), e392-e408. https://doi.org/10.3747/co.23.3073
Section
Review Article