Cost-effectiveness of particle therapy: current evidence and future needs.
OBJECTIVE
Questions are being raised regarding the cost of particle therapy (PT), and with them criticism that PT is too expensive to allow the expected gain in effectiveness. This paper aims to get more insight in the cost and cost-effectiveness of particle therapy and to discuss a future strategy that allows for critical assessment of this health technology.


METHODS
A systematic literature review based on an earlier published comprehensive review was performed and updated until June 1st 2008. Besides, current business plans of PT projects were examined. Additionally, results retrieved from a cost-simulation tool developed under auspice of the ENLIGHT were discussed.


RESULTS
The current literature on cost-effectiveness of PT is scarce, non-comparable, and largely not performed according to standard health technology assessment criteria. Besides, different perspectives for cost evaluations have been used, making it difficult to compare and to determine the relative impact in terms of costs for this new treatment modality.


CONCLUSIONS
Evidence on the cost-effectiveness of PT is scarce. Adequate reimbursement is necessary to support such innovative yet costly treatments. For now, model-based economic evaluations performed at least from a health care perspective may help us to gain evidence-based insight into cost-effectiveness.
Pijls-Johannesma
Madelon
M
Maastricht Radiation Oncology (MAASTRO Clinic), University Medical Center, Maastricht, The Netherlands. madelon.pijls@maastro.nl
Pommier
Pascal
P
Lievens
Yolande
Y
D003362:Cost-Benefit Analysis; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D010315:Particle Accelerators; D061766:Proton Therapy; D018787:Radiation Oncology / Q000191:economics*; D011522:Protons
D011522:Protons