A cost comparison of the use of fixed versus non-fixed versus individualised shielding blocks in radiotherapy

The investment and operating costs for the manufacturing and application of routine shielding techniques in patients receiving radiotherapy are described. It was found that the operating cost of a fixed block is lower than that of the other types of blocks. Non-fixed and individualised blocks have similar operating costs. Whereas the manufacturing costs are much lower for non-fixed blocks than for individualised blocks, their application costs (for daily placement) are much higher, implying that the cost per piece of both types of blocks is more or less identical. Departments that have all the equipment for the manufacturing of individual blocks available are recommended to use standard-fixed blocks in patients where there is no clear preference for a specific type of block. Individual blocks, because of their higher cost, should be used only when they are judged to be superior for the patient. Investment decisions for equipment can be based on a similar strategy. Only if one intends to use blocks in very few patients (less than 60/year), are non-fixed blocks the cheapest alternative. If more blocks are used, it is sufficient to invest in standard-fixed blocks equipment, unless individual blocks are recommended for medical reasons.