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CHART in lung cancer: economic evaluation and incentives for implementation
Yolande Lievens1, Katrien Kesteloot, Walter Van den Bogaert
1Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium. yolande.lievens@uz.kuleuven.ac.be
Summary
Continuous Hyperfractionated Accelerated Radiotherapy (CHART) is cost-effective for non-small cell lung cancer (NSCLC). Despite clinical benefits, implementation barriers remain, not economic concerns.
Area of Science:
- Oncology
- Health Economics
- Radiotherapy
Background:
- Continuous Hyperfractionated Accelerated Radiotherapy (CHART) is a treatment modality for lung cancer.
- The economic impact and daily implementation of CHART require thorough investigation.
Purpose of the Study:
- To assess the cost-effectiveness and cost-utility of CHART for non-small cell lung cancer (NSCLC).
- To identify factors influencing the daily implementation of CHART in clinical practice.
Main Methods:
- Markov models were utilized for cost-effectiveness and cost-utility analyses over a 4-year period.
- Societal perspective was adopted, incorporating data from literature and hospital cost estimates.
- Activity-based costing (ABC) was used for radiotherapy cost derivation.
Main Results:
- The incremental cost per life-year gained was 9164 Euro.
- The incremental cost per quality-adjusted life-year (QALY) was 11,576 Euro.
- Sensitivity analyses confirmed the robustness of results, with the incremental cost-utility ratio consistently below 20,000 Euro/QALY.
Conclusions:
- CHART is a clinically and economically viable option for NSCLC patients.
- Barriers to daily implementation are likely socio-economical, institutional, and physician-related, rather than clinical or economic.