Évaluation du coût de la radiothérapie asservie à la respiration dans le cadre d’un projet Stic

Abstract: Purpose: Our study aims to evaluate the impact of the implementation of respiratory gating (RG) on the production cost of radiotherapy, as compared to conformational radiotherapy without RG (comparator) in patients with lung or breast cancers. Issues surrounding reimbursement were also explored. Materials and methods: A prospective, multicenter, non-randomised study was conducted in the framework of a project entitled “Support Program for Costly Diagnostic and Therapeutic Innovations”. Of the 20 hospitals involved in the clinical study, eight reference centers participated to the medico-economic study evaluating the costs of staff and equipment, as well as the costs of maintenance and consumables. Results: Three hundred and sixty-five patients were enrolled over two years in the economic study, corresponding to 197 radiotherapy treatments without RG and 168 with RG. Patients treated during the learning phase (n =27) were excluded from the comparison with the control group. The use of RG in routine practice induced a cost increase of respectively €1256 and €996 per treatment for lung and breast cancer patients treated with breath-hold techniques, versus €1807 and €1510 for lung and breast cancer patients treated with synchronized gating techniques. Overcosts were mainly due to extra working time of medical staff and medical technicians and to extra use of equipments during treatment sessions. Conclusion: The results of the full cost estimation suggested that medical reimbursements largely underestimate the costs related to innovation. [Copyright &y& Elsevier]