Economic evaluation of proton radiation therapy in the treatment of breast cancer.
OBJECTIVE
Proton beam therapy offers potential clinical advantages compared with conventional radiation therapy for many cancer patients. The benefits are mainly a result of a more favourable dose distribution. The treatment cost with proton radiation is higher than for conventional radiation, mainly due to the large investment cost of building a proton therapy facility. It is therefore important to evaluate whether the medical benefits of proton therapy are large enough to justify the higher treatment costs, compared with conventional radiation therapy.


METHODS
The cost-effectiveness of proton therapy in the treatment of 55-year old women with left-sided breast cancer was assessed. A Markov cohort simulation model was used to simulate the life of patients diagnosed with breast cancers and treated with radiation. Cost and quality adjusted life years (QALYs) were the primary outcome measures.


RESULTS
The study found a cost per QALY gained of 67,000 Euro for the base case analysis of an average breast cancer patient. The cost per QALY gained would, however, be considerably lower if a population with high-risk of developing cardiac disease was treated. Sensitivity analyses showed that the results were stable and that the risk of cardiac disease was the most important parameter.


CONCLUSIONS
The results indicate that proton therapy for breast cancer can be cost-effective if appropriate risk groups are chosen as targets for the therapy.
Lundkvist
Jonas
J
Medical Management Centre, Karolinska Institute, Stockholm, Sweden. jonas.l@healtheconomics.se
Ekman
Mattias
M
Ericsson
Suzanne Rehn
SR
Isacsson
Ulf
U
Jönsson
Bengt
B
Glimelius
Bengt
B
D001943:Breast Neoplasms / Q000191:economics* / Q000532:radiotherapy*; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D061766:Proton Therapy; D019057:Quality-Adjusted Life Years; D011878:Radiotherapy / Q000191:economics*; D018570:Risk Assessment; D011522:Protons
D011522:Protons