Cost-minimization analysis: radiation treatment with and without a multi-leaf collimator

Area of Science:

• Radiation Oncology
• Medical Physics
• Health Economics

Background:

• Linear accelerators are crucial for delivering radiation therapy.
• Multileaf collimators (MLCs) shape radiation beams, potentially improving efficiency.
• The cost-effectiveness of MLCs in clinical practice requires evaluation.

Purpose of the Study:

• To compare the costs of radiation treatment using linear accelerators with and without multileaf collimators (MLCs).
• To determine if increased patient throughput and reduced block cutting costs justify the institutional investment in MLCs.

Main Methods:

• Prospective data collection on fields treated, treatment equivalents, and blocks used for four linear accelerators.
• Acquisition of building, equipment, staffing, and service costs in Australian dollars.
• Analysis conducted at a joint radiation oncology center in Australian public hospitals.

Main Results:

• Linear accelerators with MLCs treated 12% more fields (5,169 vs. 4,543) per machine over three months.
• MLC machines required significantly fewer premounted trays (17 vs. 155).
• Despite higher capital costs, MLCs resulted in lower per-field costs ($A101.69 vs. $A106.98) due to increased throughput and reduced labor, yielding potential annual savings of $A168,000–$A680,000.

Conclusions:

• The implementation of multileaf collimators (MLCs) on linear accelerators is cost-effective for radiation oncology departments.
• Increased efficiency and reduced operational costs justify the capital investment in MLC technology.
• MLC use can be financially justified in similar radiation oncology settings.