title: Proton therapy of cancer: potential clinical advantages and cost-effectiveness.
abstract: Proton therapy may offer potential clinical advantages compared with conventional radiation therapy for many cancer patients. Due to the large investment costs for building a proton therapy facility, however, the treatment cost with proton radiation is higher than with conventional radiation. It is therefore important to evaluate whether the medical benefits of proton therapy are large enough to motivate the higher costs. We assessed the cost-effectiveness of proton therapy in the treatment of four different cancers: left-sided breast cancer, prostate cancer, head and neck cancer, and childhood medulloblastoma. A Markov cohort simulation model was created for each cancer type and used to simulate the life of patients treated with radiation. Cost and quality adjusted life years (QALYs) were used as primary outcome measures. The results indicated that proton therapy was cost-effective if appropriate risk groups were chosen. The average cost per QALY gained for the four types of cancer assessed was about pounds 10,130. If the value of a QALY was set to pounds 55,000, the total yearly net benefit of treating 925 cancer patients with the four types of cancer was about pounds 20.8 million. Investment in a proton facility may thus be cost-effective. The results must be interpreted with caution, since there is a lack of data, and consequently large uncertainties in the assumptions used.
authors.affiliation: Stockholm Health Economics, Stockholm, Sweden. jonas.l@healtheconomis.se
authors.forename: Jonas
authors.initials: J
authors.lastname: Lundkvist
authors.forename: Mattias
authors.initials: M
authors.lastname: Ekman
authors.forename: Suzanne Rehn
authors.initials: SR
authors.lastname: Ericsson
authors.forename: Bengt
authors.initials: B
authors.lastname: Jönsson
authors.forename: Bengt
authors.initials: B
authors.lastname: Glimelius
mesh_terms: D000368:Aged; D002675:Child, Preschool; D015331:Cohort Studies; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009369:Neoplasms / Q000191:economics* / Q000532:radiotherapy*; D061766:Proton Therapy; D019057:Quality-Adjusted Life Years; D011878:Radiotherapy / Q000191:economics*; D013548:Sweden; D011522:Protons
chemical_list: D011522:Protons