Online

WCB 2021 - Online

Session Item

Friday
May 07
08:00 - 08:40
Using health economics to make the case for brachytherapy – HALYS, QALYS and DALYS
0130
Teaching lecture
08:00 - 08:40
Using health economics to make the case for brachytherapy – HALYS, QALYS and DALYS
Danielle Rodin, Canada;
Michael Milosevic, Canada
SP-0049

Abstract

Using health economics to make the case for brachytherapy – HALYS, QALYS and DALYS
Authors: Michael Milosevic(Princess Margaret Cancer Centre , University of Toronto, Toronto, Canada), Danielle Rodin(Princess Margaret Cancer Centre , University of Toronto, Toronto, Canada)
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Abstract Text

Brachytherapy is essential in the definitive management of many gynecological cancers, including locally advanced cervical or vaginal cancers. However, brachytherapy is underutilized in many parts of the world despite clear dosimetric and survival advantages compared to even the most conformal EBRT techniques. Many factors may be contributing to this, including the costs associated with investing in new technology, training personnel and maintaining competency. In many low and middle income countries where gynecologic cancers are among the most common and most debilitating diseases, brachytherapy is not available at all and the investment needed to address this disparity is often perceived to be high and without economic payback. In more developed parts of the world, economic concerns about higher infrastructure and personnel costs often constrain the transition from ‘one-size-fits-all’ 2D brachytherapy to more conformal, image-guided techniques with the potential for improved tumor control and fewer side effects.

Investment in healthcare technology reflects a priority-setting process in which governments and payers decide how to allocate scarce healthcare resources. Economic evaluation provides decision-makers with common metrics to determine the value for money of investment in one healthcare tool over another.

M. Milosevic

Princess Margaret Cancer Centre and University of Toronto, Toronto, Canada

This presentation will review the economic evidence to support investing in image-guided brachytherapy for gynecological cancer from the perspective of patients, individual cancer treatment programs and the healthcare payer, with a focus on the cost-effectiveness of MR-guided brachytherapy for cervical cancer. The case will be made that best-practice MR-guided brachytherapy can be economically attractive compared to CT-guided brachytherapy or 2D brachytherapy by improving clinical outcomes and saving money. The path to scale-up of MR-guided brachytherapy in Ontario, Canada by assisting policy-makers with future infrastructure and human resource planning will be outlined as a model that can be adapted to other jurisdictions and practice settings.

D. Rodin, Princess Margaret Cancer Centre and University of Toronto, Toronto, Canada

This presentation will provide an overview of the different forms of economic evaluation and health technology assessment tools and will apply these concepts to brachytherapy. Drawing from the cervical cancer literature, it will use a macroeconomic approach to healthcare investment and will review how cost-benefit analyses can demonstrate the health and economic benefits of radiotherapy in different resource settings. By viewing women with cancer as productive members of the labour force and of their community, a strong investment case for making brachytherapy available can be demonstrated to decision-makers.