Can costs be measured and predicted by modeling within a cooperative clinical trials group? Economic methodologic pilot studies of the radiation therapy oncology group (RTOG) studies 90-03 and 91-04.
OBJECTIVE
To (1) measure radiation therapy costs for patients in randomized controlled clinical trials, (2) compare measured costs to modeling predictions, (3) examine cost distributions, and (4) assess feasibility of collecting economic data within a cooperative group.


METHODS
The Radiation Therapy Oncology Group conducted economic pilot studies for two Phase III studies that compared fractionation patterns. Expected quantities of Current Procedural Terminology (CPT) codes and relative value units (RVU) were modeled. Institutions retrospectively provided procedure codes, quantities, and components, which were converted to RVUs used for Medicare payments. Cases were included if the radiation therapy quality control review judged them to have been treated per protocol or with minor variation. Cases were excluded if economic quality review found incomplete economic data.


RESULTS
The median and mean RVUs were within the range predicted by the model for all arms of one study and above the predicted range for the other study.


CONCLUSIONS
The model predicted resource use well for patients who completed treatment per protocol. Actual economic data can be collected for critical cost items. Some institutions experienced difficulty collecting retrospective data, and prospective collection of data is likely to allow wider participation in future Radiation Therapy Oncology Group economic studies.
Owen
J B
JB
Radiation Therapy Oncology Group, American College of Radiology, 1101 Market Street, Suite 1400, Philadelphia, PA 19107, USA. jowen@phila.acr.org
Grigsby
P W
PW
Caldwell
T M
TM
Konski
A A
AA
Johnson
D J
DJ
Demas
W F
WF
Movsas
B
B
Jones
C U
CU
Wasserman
T H
TH
D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D017326:Clinical Trials, Phase III as Topic / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000379:methods*; D003625:Data Collection; D005240:Feasibility Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D018803:Models, Economic; D010865:Pilot Projects; D018787:Radiation Oncology / Q000191:economics*; D016032:Randomized Controlled Trials as Topic / Q000191:economics*; D012189:Retrospective Studies