Developing time-driven activity-based costing at the national level to support policy recommendations for radiation oncology in Belgium - PDF Version

Noémie Defourny, Sophie Hoozée, Jean-François Daisne, Yolande Lievens

J. Account. Public Policy: 2022:107013.

The health economics for radiation oncology (HERO) project began in 2010, thanks to the European SocieTy for Radiotherapy and Oncology (ESTRO). The project is aimed to develop a knowledge base for the economic evaluation of radiation treatment in European countries in terms of both financial and health costs. It provides solid data to the radiotherapy community to support their dialogues with governments, payers and decision-makers to advocate for both better resource planning and better funding for radiotherapy, which ultimately lead to better care for cancer patients.

In August 2022, the first national results of the cost accounting model were published in the Journal of Accounting and Public Policy. The authors assess the intricacies of applying the ESTRO-HERO tool1, a time-driven, activity-based costing method, to inform price-setting policy at a national level for external beam radiotherapy. They discuss the policy implications in terms of both the updating of legal recommendations and the development of a new reimbursement system in the Belgian setting.

This national application of the ESTRO-HERO costing tool was only possible thanks to close collaboration with the Belgian workgroup for the revision of the nomenclature and accreditation norms. We thank Paul Meijnders (Belgian SocieTy for Radiotherapy and Oncology, BeSTRO), Aude Vaandering (Association of French-speaking Belgian Nurses and Technologists in Radiotherapy, AFITER), Marc Brosens (BeSTRO), Vincent Remouchamps (BeSTRO), Jan Vandecasteele (Belgian Hospital Physicists Association, BHPA), Nadine Linthout (BHPA), Jean Vanderick (Belgian Association of Radiation Oncology, BARO), Karen Haest (Federal Agency for Nuclear Control, FANC/AFCN), Katleen Luyten (Flemish Association for Nurses in Radiotherapy and Oncology, VVRO), Sven D’Haese (VVRO), Walter Hontoir (AFITER) and Ann Vermylen (VVRO) for their dedicated effort.

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1The ESTRO-HERO tool is available online. Requests to use it can be sent to Chiara Gasparotto at ESTRO: .


Noémie Defourny
Division of Cancer Sciences
University of Manchester
Manchester Cancer Research Centre
Manchester Academic Health Science Centre
Manchester, UK