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Cost-effectiveness analysis using lifetime attributable risk of proton beam therapy for pediatric medulloblastoma in

Takaaki Yoshimura1,2, Honoka Tamori3, Yasuhiro Morii4

  • 1Department of Health Sciences and Technology, Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan.

Journal of Radiation Research
|September 30, 2021
PubMed

Insights

Proton beam therapy (PBT) is more cost-effective than conventional X-ray therapy for pediatric medulloblastoma. PBT significantly reduces the risk of secondary cancers, improving patient quality of life.

Area of Science:

  • Oncology
  • Radiation Oncology
  • Health Economics

Background:

  • Proton beam therapy (PBT) offers advantages over conventional X-ray therapy for pediatric medulloblastoma, including reduced radiation dose to normal tissues.
  • However, the higher cost of PBT necessitates a thorough cost-effectiveness evaluation.

Purpose of the Study:

  • To compare the cost-effectiveness of PBT versus conventional X-ray therapy for pediatric medulloblastoma.
  • To specifically assess the impact on reducing the risk of rare, serious radiation-induced secondary cancers and their effect on quality of life (QOL).

Main Methods:

  • A decision tree model was employed for cost-effectiveness analysis from a healthcare payer perspective.
  • Data was derived from a systematic review, focusing on pediatric patients (<14 years) with medulloblastoma.
  • The primary outcome was the incremental cost-effectiveness ratio (ICER) based on cost and lifetime attributable risk (LAR) of secondary cancers over a 7.7-year time horizon with a 2% discount rate.

Main Results:

  • Conventional X-ray therapy incurred costs of JPY 1,067,608 with a 42% LAR.
  • Proton beam therapy (PBT) incurred costs of JPY 2,436,061 with a significantly lower 7% LAR.
  • The calculated ICER was JPY 3,856,398 per unit reduction in LAR.

Conclusions:

  • Proton beam therapy (PBT) demonstrates superior cost-effectiveness compared to conventional X-ray therapy in mitigating secondary cancer risks for pediatric medulloblastoma.
  • The developed ICER, incorporating LAR, serves as a valid metric for evaluating cost-effectiveness in the context of radiation-induced secondary cancers.

Keywords:
cost-effectivenesslifetime attribute riskmedulloblastomaproton therapysecondary cancer

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