Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av Dr Arnaldo 455, CEP: 01246903, Sao Paulo, SP, Brazil.
Servico de Radioterapia, Hospital das Clínicas da Faculdade de Medicina FMUSP, Instituto do Cancer do Estado de Sao Paulo, Universidade de Sao Paulo (ICESP), Sao Paulo, SP, Brazil.
BMC Health Serv Res. 2024 Nov 26;24(1):1466. doi: 10.1186/s12913-024-11969-y.
Lung cancer is one of the leading causes of morbidity and mortality in Brazil. Radiotherapy is an important therapeutic option, but the techniques used remain subjects of discussion. In this study, we compared the costs of conventional radiotherapy (CRT) and stereotactic ablative radiotherapy (SABR) in the treatment of early-stage non-small cell lung cancer (NSCLC).
This cost analysis study adopted a micro-costing approach, following the TDABC (Time-Driven Activity-Based Costing) methodology. The study was conducted at a specialized public cancer hospital in São Paulo, Brazil. The analysis involved seven macro-processes related to radiotherapy treatment, identifying resources, costs, and time estimates for each step.
The cost analysis revealed that SABR treatment for NSCLC is significantly cheaper than CRT. The direct costs of SABR treatment ranged from $2,777.25 to $3,797.49, while CRT ranged from $5,562.65 to $6,052.94. The cost related to CRT treatment constituted more than 80% of the total costs, whereas in SABR, it ranges from 59 to 68%. Planning represented 9% to 10% of the cost in CRT, increasing to 22% to 30% in SABR.
The results highlight that SABR treatment is a cheaper option for early-stage NSCLC patients when compared to CRT. Furthermore, the increased time required for CRT treatment limits the number of patients who can be treated. These results may influence healthcare policies and the financing of the healthcare system, directly benefiting patients and promoting the efficient allocation of resources.
肺癌是巴西发病率和死亡率最高的疾病之一。放射治疗是一种重要的治疗选择，但所使用的技术仍存在争议。在这项研究中，我们比较了常规放射治疗（CRT）和立体定向消融放射治疗（SABR）在治疗早期非小细胞肺癌（NSCLC）中的成本。
本成本分析研究采用微观成本法，遵循 TDABC（时间驱动作业成本法）方法。该研究在巴西圣保罗的一家专门的公立癌症医院进行。该分析涉及与放射治疗相关的七个宏观流程，确定了每个步骤的资源、成本和时间估算。
成本分析表明，SABR 治疗 NSCLC 的成本明显低于 CRT。SABR 治疗 NSCLC 的直接成本为 2777.25 美元至 3797.49 美元，而 CRT 的直接成本为 5562.65 美元至 6052.94 美元。SABR 治疗相关的成本构成了总成本的 80%以上，而 CRT 治疗相关的成本构成了总成本的 60%至 70%。计划在 CRT 治疗中占成本的 9%至 10%，在 SABR 治疗中增加到 22%至 30%。
结果表明，与 CRT 相比，SABR 治疗是早期 NSCLC 患者更便宜的选择。此外，CRT 治疗所需的时间增加限制了可以治疗的患者数量。这些结果可能会影响医疗保健政策和医疗保健系统的融资，直接使患者受益，并促进资源的有效配置。
