Economic Evaluation of Particle Therapy for Cancer Treatment: A Systematic Review

Particle therapy represents a cutting-edge modality in radiation oncology that offers potential advantages over conventional radiation therapy; however, its cost-effectiveness has not been established. We conducted a systematic search of several electronic databases to synthesize contemporary evidence on the cost-effectiveness of particle therapy. The methodological quality of the included studies was assessed, and reported outcomes on costs, health benefits, and incremental cost-effectiveness ratios (ICERs) were extracted. We identified 57 studies, which collectively reported 134 comparisons for particle therapies. In general, studies were of good quality, although better reporting of data sources and modeling assumptions is warranted. Included studies primarily evaluated the cost-effectiveness of proton therapy, used photon therapy as the comparator, utilized a Markov Cohort model, and used the payer's perspective. Findings were inconsistent, with the reported ICERs ranging from $55 to $1,066,266 per unit of benefit gained, with discrepancies across cancer sites and treatment modalities. Particle therapy is cost-effective for specific groups but may not be universally cost-effective. More research is warranted to identify subgroups for which particle therapy is cost-effective.