Ploquin Nicolas Paul, Dunscombe Peter Brian
Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alta., Canada.
Radiother Oncol. 2008 Feb;86(2):217-23. doi: 10.1016/j.radonc.2008.01.005. Epub 2008 Jan 30.
The rising cost of health care is of universal concern. If the cost effectiveness of conventional and novel radiotherapeutic strategies is to be established we need to have confidence in our estimates of both cost and effectiveness. The purpose of this study is to explore the degree of consistency of recently published cost estimates for radiation therapy.
Eleven publications form the basis of this analysis. From each study we have estimated the cost of a 21 fraction course (when possible) of radiation therapy. The costs have been decomposed into the three inputs: process, clinical infrastructure and supporting infrastructure. We have also investigated the time course of radiation therapy costs over the last two decades.
From the latest four studies we conclude that the cost of a 21 fraction course of radiation therapy is 3239 euro+/-566 euro. The percentages of this total spent on process, clinical infrastructure and supporting infrastructure over the last 15 years are 54, 29 and 17, respectively. The real increase in the cost of radiotherapy over the last 15 years is estimated to be approximately 5.5%.
Cost estimates for radiation therapy appear to be converging. However, we will need far more sophisticated analyses in the future if we are to establish the cost effectiveness of the newer treatment strategies currently under active clinical investigation.
医疗保健成本的不断上升是全球普遍关注的问题。若要确定传统和新型放射治疗策略的成本效益，我们需要对成本和效益的估算有信心。本研究的目的是探讨近期发表的放射治疗成本估算的一致程度。
本分析基于11篇出版物。我们从每项研究中估算了一个21次分割疗程（若可能）的放射治疗成本。成本已分解为三个投入要素：流程、临床基础设施和支持性基础设施。我们还研究了过去二十年放射治疗成本的时间变化过程。
从最近的四项研究中我们得出结论，一个21次分割疗程的放射治疗成本为3239欧元±566欧元。在过去15年中，该总成本在流程、临床基础设施和支持性基础设施上的支出百分比分别为54%、29%和17%。过去15年放射治疗成本的实际增长估计约为5.5%。
放射治疗的成本估算似乎正在趋于一致。然而，如果我们要确定目前正在积极进行临床研究的新型治疗策略的成本效益，未来我们将需要进行更为复杂的分析。
