BUDGET IMPACT ASSESSMENT (BIA) OF INTRAOPERATIVE RADIOTHERAPY (IORT) IN THE GERMAN EARLY BREAST CANCER PATIENTS

• Published in: Value in health 2017-05, Vol.20 (5), p.A97
• Main Authors: Vaidya, A, Vaidya, P, Both, B
• Format: Article
• Language: English
• Subjects: Biological organs; Breast cancer; Compliance; Epidemiology; First year; Health care; Medical diagnosis; Oncology; Patients; Quality of life; Radiation; Radiation therapy; Radiotherapy; Sensitivity analysis; Uptake
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.05.005

OBJECTIVES: To evaluate the potential budget impact of early breast cancer treatment using IORT to inform the reimbursement policy decisions. The IORT (as definite dose or as boost) eliminates the need for numerous radiation center visits and minimizes radiation exposure to healthy tissue and organs. METHODS: An incidence-based budget impact model in MS Excel was developed over a five-year time horizon employing the German health care system perspective. Epidemiologic data were used to quantify the proportion of patients diagnosed with early breast cancer in Germany. Two scenarios were examined; one with progressive uptake of IORT over the time horizon and other with 100% uptake of IORT from the introduction year. Diagnosis Related Group based IORT base case cost was varied in a reasonable range for the sensitivity analysis. RESULTS: With the progressive introduction of IORT the total annual cost of treatment for early breast cancer patients in Germany gradually decline from 244 Million Euros in the first year to 189 Million Euros in the fifth year. Therefore, introduction of IORT in phasic manner could save 241 Million Euros over the next five years. In the alternative scenario, where all patients are treated with IORT from the introduction year, the annual cost saving for the payer would be 78 million Euros. Therefore, aggressive introduction of IORT would save 389 Million Euros over the tie horizon which translates to the additional cost saving of 148 Million Euros in comparison with the phasic introduction. CONCLUSIONS: IORT (boost and single treatment) is the cost saving treatment strategy for patients with early-stage breast cancer. The impact of IORT treatment decision extends beyond these model results as the implementation of this shorter radiation course could improve quality of life by sparing patients from the protracted course of conventional radiotherapy, improve compliance, prevent unnecessary mastectomies and save valuable health care resources.