title: Multinational assessment of some operational costs of teletherapy.
abstract: OBJECTIVE
  Decisions in planning radiotherapy facilities in countries with limited financial resources require information on economic factors to make provision for sustainability. This study aims at acquiring data on some of these factors involved in delivery of teletherapy in 11 countries of different economic status.
  
  
  METHODS
  Representatives of three European, one African, three Latin American and four Asian countries, were identified from radiation oncology institutions that operated both cobalt and linac teletherapy machines. Productivity data were prospectively collected for the year 2002. A detailed log was recorded for each machine over an arbitrary two-week period. Data on quality assurance (QA), maintenance, the capital costs of each machine, and the source replacement costs for the cobalt units were also recorded.
  
  
  RESULTS
  Both linear accelerators and cobalt machines treat more than 10,000 fractions per year per machine with 2.5 and 2.3 fields per fraction, respectively. The capital costs of the machines vary considerably, with a factor of more than 10 for linear accelerators. Cobalt sources show a huge variation in price. The median costs of QA and maintenance of a linac was US$ 41,000 compared to US$ 6000 for cobalt machines. This results for the economic factors considered in median costs per fraction of US$ 11.02 for linear accelerators and US$ 4.87 for cobalt machines. These figures do not include the costs for physicians.
  
  
  CONCLUSIONS
  The variation of the costs per fraction is more due to the result of differences in machine usage and costs of equipment than of national economic status. A treatment fraction on a linac with functionality comparable to cobalt, costs 50% more than cobalt therapy. This project shows that it is possible to collect data on economic factors prospectively as well as retrospectively.
authors.affiliation: Dr. Bernard Verbeeten Instituut, Brugstraat 10, 5042 SB Tilburg, The Netherlands.
authors.forename: Piet-Hein
authors.initials: PH
authors.lastname: Van Der Giessen
authors.forename: Jose
authors.initials: J
authors.lastname: Alert
authors.forename: Cholid
authors.initials: C
authors.lastname: Badri
authors.forename: Matija
authors.initials: M
authors.lastname: Bistrovic
authors.forename: Deepak
authors.initials: D
authors.lastname: Deshpande
authors.forename: Dimitris
authors.initials: D
authors.lastname: Kardamakis
authors.forename: Debbie
authors.initials: D
authors.lastname: Van Der Merwe
authors.forename: Neiro
authors.initials: N
authors.lastname: Da Motta
authors.forename: Luis
authors.initials: L
authors.lastname: Pinillos
authors.forename: Rena
authors.initials: R
authors.lastname: Sajjad
authors.forename: Ye
authors.initials: Y
authors.lastname: Tian
authors.forename: Vic
authors.initials: V
authors.lastname: Levin
mesh_terms: D002201:Capital Expenditures; D003365:Costs and Cost Analysis / Q000191:economics; D003906:Developing Countries / Q000191:economics*; D004467:Economics; D008283:Maintenance / Q000191:economics; D017059:Models, Econometric; D010315:Particle Accelerators / Q000191:economics*; D011867:Radioisotope Teletherapy / Q000191:economics*; D013673:Technology Assessment, Biomedical