Activity-Based Costing of Intensity-Modulated Proton versus Photon Therapy for Oropharyngeal Cancer
Purpose: In value-based health care delivery, radiation oncologists need to compare empiric costs of care delivery with advanced technologies, such as intensity-modulated proton therapy (IMPT) and intensity-modulated radiation therapy (IMRT). We used time-driven activity-based costing (TDABC) to com...
| Principais autores: | , , , , , , , , , , , , , , , |
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| Formato: | Artigo |
| Idioma: | English |
| Publicado em: |
Elsevier
2021-06-01
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| coleção: | International Journal of Particle Therapy |
| Assuntos: | |
| Acesso em linha: | https://theijpt.org/doi/pdf/10.14338/IJPT-20-00042.1 |
| _version_ | 1827158260536311808 |
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| author | Nikhil G. Thaker, MD David Boyce-Fappiano, MD Matthew S. Ning, MD Dario Pasalic, MD Alexis Guzman, MBA Grace Smith, MD, PhD, MPH Emma B. Holliday, MD James Incalcaterra, PhD Adam S. Garden, MD Simona F. Shaitelman, MD G. Brandon Gunn, MD C. David Fuller, MD, PhD Pierre Blanchard, MD Thomas W. Feeley, MD Robert S. Kaplan, PhD Steven J. Frank, MD |
| author_facet | Nikhil G. Thaker, MD David Boyce-Fappiano, MD Matthew S. Ning, MD Dario Pasalic, MD Alexis Guzman, MBA Grace Smith, MD, PhD, MPH Emma B. Holliday, MD James Incalcaterra, PhD Adam S. Garden, MD Simona F. Shaitelman, MD G. Brandon Gunn, MD C. David Fuller, MD, PhD Pierre Blanchard, MD Thomas W. Feeley, MD Robert S. Kaplan, PhD Steven J. Frank, MD |
| author_sort | Nikhil G. Thaker, MD |
| collection | DOAJ |
| description | Purpose: In value-based health care delivery, radiation oncologists need to compare empiric costs of care delivery with advanced technologies, such as intensity-modulated proton therapy (IMPT) and intensity-modulated radiation therapy (IMRT). We used time-driven activity-based costing (TDABC) to compare the costs of delivering IMPT and IMRT in a case-matched pilot study of patients with newly diagnosed oropharyngeal (OPC) cancer.
Materials and Methods: We used clinicopathologic factors to match 25 patients with OPC who received IMPT in 2011-12 with 25 patients with OPC treated with IMRT in 2000-09. Process maps were created for each multidisciplinary clinical activity (including chemo-therapy and ancillary services) from initial consultation through 1 month of follow-up. Resource costs and times were determined for each activity. Each patient-specific activity was linked with a process map and TDABC over the full cycle of care. All calculated costs were normalized to the lowest-cost IMRT patient.
Results: TDABC costs for IMRT were 1.00 to 3.33 times that of the lowest-cost IMRT patient (mean ± SD: 1.65 ± 0.56), while costs for IMPT were 1.88 to 4.32 times that of the lowest-cost IMRT patient (2.58 ± 0.39) (P < .05). Although single-fraction costs were 2.79 times higher for IMPT than for IMRT (owing to higher equipment costs), average full cycle cost of IMPT was 1.53 times higher than IMRT, suggesting that the initial cost increase is partly mitigated by reductions in costs for other, non-RT supportive health care services.
Conclusions: In this matched sample, although IMPT was on average more costly than IMRT primarily owing to higher equipment costs, a subset of IMRT patients had similar costs to IMPT patients, owing to greater use of supportive care resources. Multidimensional patient outcomes and TDABC provide vital methodology for defining the value of radiation therapy modalities. |
| first_indexed | 2024-04-24T08:22:58Z |
| format | Article |
| id | doaj.art-cf65fa9349e74f5c90a30784d33440e6 |
| institution | Directory Open Access Journal |
| issn | 2331-5180 |
| language | English |
| last_indexed | 2025-03-20T23:38:25Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Particle Therapy |
| spelling | doaj.art-cf65fa9349e74f5c90a30784d33440e62024-08-03T13:39:06ZengElsevierInternational Journal of Particle Therapy2331-51802021-06-018137438210.14338/IJPT-20-00042.1i2331-5180-8-1-374Activity-Based Costing of Intensity-Modulated Proton versus Photon Therapy for Oropharyngeal CancerNikhil G. Thaker, MD0David Boyce-Fappiano, MD1Matthew S. Ning, MD2Dario Pasalic, MD3Alexis Guzman, MBA4Grace Smith, MD, PhD, MPH5Emma B. Holliday, MD6James Incalcaterra, PhD7Adam S. Garden, MD8Simona F. Shaitelman, MD9G. Brandon Gunn, MD10C. David Fuller, MD, PhD11Pierre Blanchard, MD12Thomas W. Feeley, MD13Robert S. Kaplan, PhD14Steven J. Frank, MD151 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA3 The Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA3 The Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA4 Harvard Business School, Boston, MA, USA4 Harvard Business School, Boston, MA, USA1 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USAPurpose: In value-based health care delivery, radiation oncologists need to compare empiric costs of care delivery with advanced technologies, such as intensity-modulated proton therapy (IMPT) and intensity-modulated radiation therapy (IMRT). We used time-driven activity-based costing (TDABC) to compare the costs of delivering IMPT and IMRT in a case-matched pilot study of patients with newly diagnosed oropharyngeal (OPC) cancer. Materials and Methods: We used clinicopathologic factors to match 25 patients with OPC who received IMPT in 2011-12 with 25 patients with OPC treated with IMRT in 2000-09. Process maps were created for each multidisciplinary clinical activity (including chemo-therapy and ancillary services) from initial consultation through 1 month of follow-up. Resource costs and times were determined for each activity. Each patient-specific activity was linked with a process map and TDABC over the full cycle of care. All calculated costs were normalized to the lowest-cost IMRT patient. Results: TDABC costs for IMRT were 1.00 to 3.33 times that of the lowest-cost IMRT patient (mean ± SD: 1.65 ± 0.56), while costs for IMPT were 1.88 to 4.32 times that of the lowest-cost IMRT patient (2.58 ± 0.39) (P < .05). Although single-fraction costs were 2.79 times higher for IMPT than for IMRT (owing to higher equipment costs), average full cycle cost of IMPT was 1.53 times higher than IMRT, suggesting that the initial cost increase is partly mitigated by reductions in costs for other, non-RT supportive health care services. Conclusions: In this matched sample, although IMPT was on average more costly than IMRT primarily owing to higher equipment costs, a subset of IMRT patients had similar costs to IMPT patients, owing to greater use of supportive care resources. Multidimensional patient outcomes and TDABC provide vital methodology for defining the value of radiation therapy modalities.https://theijpt.org/doi/pdf/10.14338/IJPT-20-00042.1proton radiation therapyimptoropharyngeal carcinomaimrttdabctime-driven activity-based costing |
| spellingShingle | Nikhil G. Thaker, MD David Boyce-Fappiano, MD Matthew S. Ning, MD Dario Pasalic, MD Alexis Guzman, MBA Grace Smith, MD, PhD, MPH Emma B. Holliday, MD James Incalcaterra, PhD Adam S. Garden, MD Simona F. Shaitelman, MD G. Brandon Gunn, MD C. David Fuller, MD, PhD Pierre Blanchard, MD Thomas W. Feeley, MD Robert S. Kaplan, PhD Steven J. Frank, MD Activity-Based Costing of Intensity-Modulated Proton versus Photon Therapy for Oropharyngeal Cancer International Journal of Particle Therapy proton radiation therapy impt oropharyngeal carcinoma imrt tdabc time-driven activity-based costing |
| title | Activity-Based Costing of Intensity-Modulated Proton versus Photon Therapy for Oropharyngeal Cancer |
| title_full | Activity-Based Costing of Intensity-Modulated Proton versus Photon Therapy for Oropharyngeal Cancer |
| title_fullStr | Activity-Based Costing of Intensity-Modulated Proton versus Photon Therapy for Oropharyngeal Cancer |
| title_full_unstemmed | Activity-Based Costing of Intensity-Modulated Proton versus Photon Therapy for Oropharyngeal Cancer |
| title_short | Activity-Based Costing of Intensity-Modulated Proton versus Photon Therapy for Oropharyngeal Cancer |
| title_sort | activity based costing of intensity modulated proton versus photon therapy for oropharyngeal cancer |
| topic | proton radiation therapy impt oropharyngeal carcinoma imrt tdabc time-driven activity-based costing |
| url | https://theijpt.org/doi/pdf/10.14338/IJPT-20-00042.1 |
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