Time-Driven Activity-Based Costing Comparison of CT-Guided Versus MR-Guided SBRT
Neil R Parikh1, Percy P Lee1, Steven S Raman2
1Department of Radiation Oncology, University of California, Los Angeles, CA.
JCO Oncology Practice
|June 17, 2020
Summary
Magnetic resonance-guided radiation therapy (MRgRT) is 18% more expensive than computed tomography-guided radiation therapy (CTgRT). Cost savings are possible with MRgRT by forgoing CT simulation or shortening treatment fractions.
Area of Science:
- Radiation Oncology
- Medical Imaging
- Health Economics
Background:
- Magnetic resonance-guided radiation therapy (MRgRT) offers advanced imaging for tumor targeting compared to computed tomography-guided radiation therapy (CTgRT).
- The cost-effectiveness of MRgRT versus CTgRT remains underexplored, particularly for localized unresectable hepatocellular carcinoma.
Purpose of the Study:
- To determine the treatment costs of MRgRT compared to CTgRT using time-driven activity-based costing.
- To analyze cost differences for localized unresectable hepatocellular carcinoma treatment.
Main Methods:
- Process mapping and interviews were used to model care cycles for both CTgRT and MRgRT.
- Treatment protocols included stereotactic body radiation therapy (50 Gy in 5 fractions) with specific guidance and delivery techniques for each modality.
Main Results:
- Direct clinical costs were $7,306 for CTgRT and $8,622 for MRgRT.
- MRgRT was 18% more expensive, with higher space and equipment costs, but lower material costs.
- Potential cost reductions for MRgRT include forgoing CT simulation or reducing treatment fractions.
Conclusions:
- MRgRT provides superior real-time image guidance and adaptive treatment capabilities.
- Despite higher baseline costs, MRgRT's value may increase with further clinical benefit elucidation.
- Cost mitigation strategies for MRgRT include optimizing treatment protocols and simulation processes.
