Considerations of cost-effectiveness for new radiation oncology technologies.
OBJECTIVE
The additional equipment and personnel costs of supplying image-guided radiation therapy (IGRT) technology have caused many to question if the marginal gains in patients' health-related quality of life are worth the additional cost. Novel IGRT technologies, including cone-beam computed tomography and helical tomotherapy, provide the opportunity to study cost and effectiveness for patients.


METHODS
This methodologic study proposes to evaluate the cost and effectiveness of treating conventional radiotherapy versus IGRT patients prospectively among several institutions. The cost of treating patients varies among institutions depending on personnel, equipment, and overhead costs, but the nature and quality of services provided are expected to be consistent.


RESULTS
The study will track cost information at a single institution and simultaneously as the median from multiple institutions. Effectiveness measures will include both standard quality-adjusted life-year instruments completed by patients and performance status measures completed by institutional personnel. In addition, disease-specific effectiveness measures will be accommodated in the study. Each participating institution will use the same effectiveness measures to track patients with similar diseases.


CONCLUSIONS
The resulting cost and effectiveness data will be available to investigators at any point during the study, immediately on the completion of a trial, or when statistical acceptability is achieved. These considerations are being incorporated into a high-level information model under development.
Mills
Michael D
MD
Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY 40202, USA. mdm@bcc.louisville.edu
Spanos
William J
WJ
Esterhay
Robert J
RJ
D003362:Cost-Benefit Analysis / Q000379:methods; D003952:Diagnostic Imaging / Q000191:economics* / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data; D018803:Models, Economic; D018787:Radiation Oncology / Q000191:economics* / Q000295:instrumentation* / Q000706:statistics & numerical data; D011881:Radiotherapy, Computer-Assisted / Q000191:economics* / Q000706:statistics & numerical data; D012106:Research; D013679:Technology, Radiologic / Q000191:economics* / Q000295:instrumentation* / Q000379:methods; D014481:United States