Economic evaluation of robotic radiosurgery system for prostate cancer treatments in the Czech Republic

Abstract

The purpose of this study was to carry out the economic evaluation of robotic stereotactic body radiation therapy (rSBRT) in comparison with conventional intensity-modulated radiation therapy (IMRT) for the treatment of localized prostate cancer in the Czech Republic. Cost-utility analysis was used for the economic evaluation of both technologies based on their costs and the number of quality-adjusted life years gained (QALYs). Utilities of both technologies were identified in literature. An estimation of treatment costs was obtained from publicly available secondary sources for the Czech Republic. The cost-utility analysis was conducted from provider’s perspective for three scenarios (optimistic, realistic, and pessimistic). According to the results of cost-utility analysis, in every scenario concerned IMRT was both more effective and less costly than rSBRT. Namely, in realistic scenario, IMRT and rSBRT accrued 9.96 QALY/53,198 CZK and 9.93 QALY/79,956 CZK, respectively. rSBRT reached the same or lower values of the cost-utility ratio than IMRT in situation, when the acquisition price of rSBRT equipment was lower than CZK 58 million in the realistic scenario. Under the conditions of the Czech healthcare system, IMRT was more cost-effective than rSBRT for localized prostate cancer treatment in all the analyzed scenarios.