Abstract
Purpose or Objective
Cost-effectiveness analysis prior to technology implementation is important, but often not performed. The international
MR-Linac Consortium works towards evidence-based introduction of the 1.5 Tesla magnetic resonance imaging radiotherapy
linear accelerator (MR-Linac). This paper aims to explore the knowledge and opinions about cost-effectiveness studies for
implementation of MR-guided radiotherapy (MRgRT).
Materials and Methods
In an online survey, members of the international MR-Linac Consortium were asked about their knowledge and use of cost-
effectiveness analysis of 1.5T MRgRT in their institutions.
Results
A total of 102 completed survey responses were received from the international MR-Linac Consortium from May to
September 2021. Among the respondents, the majority were based in Europe (65%), followed by North America (20%), Asia
(11%), Oceana (4%), and Latin America (1%). Of all respondents, 75 (74%) respondents provided MRgRT at their institution,
20 (20%) were in the process of technology installation, 2 (2%) considered technology acquirement and 5 (5%) were
unspecified.
The majority of respondents (61%) only understood the purpose cost-effectiveness analysis, 27% had no knowledge about it
and 12% indicated to fully understand it. Furthermore, 42% of all respondents indicated that the MR-Linac is being evaluated
on cost-effectiveness at their institution, 39% did not know and 19% indicated that such an evaluation was not being
performed. Of the 43 respondents evaluating cost-effectiveness, the majority (60%) lacked knowledge of the methodology
being applied or used scenario analysis, threshold analysis and/or decision analytical modelling. 54% of all respondents
perceived that demonstrating the cost-effectiveness is important for reimbursement, 28% do not know and 18% do not think so. The three most frequently mentioned reasons for not performing cost-effectiveness analysis were lack of human
resources (22%), lack of external incentive (19%) or funding (19%).
98% of all participants expected patient benefits and 62% perceived economic benefits from the MR-Linac over standard
treatment. While participants were optimistic towards technology benefits, also critical remarks were given regarding the
actual added value in the radiation oncology field, including technological complexities and the substantial staffing and
structural investments.
Conclusion
A substantial proportion of members of the MR-Linac Consortium has no or only limited knowledge about cost-effectiveness
analysis. While most participants claimed that demonstrating cost-effectiveness is important for reimbursement, the
majority had no knowledge on whether cost-effectiveness analysis was performed at their institutions or indicated that it
was not being performed. As a result, the opportunity to steer research and development within the MR-Linac Consortium
may not be optimally used. More and better understanding of cost-effectiveness is needed to improve the use and quality
of such analyses and the consortium.
Cost-effectiveness analysis prior to technology implementation is important, but often not performed. The international
MR-Linac Consortium works towards evidence-based introduction of the 1.5 Tesla magnetic resonance imaging radiotherapy
linear accelerator (MR-Linac). This paper aims to explore the knowledge and opinions about cost-effectiveness studies for
implementation of MR-guided radiotherapy (MRgRT).
Materials and Methods
In an online survey, members of the international MR-Linac Consortium were asked about their knowledge and use of cost-
effectiveness analysis of 1.5T MRgRT in their institutions.
Results
A total of 102 completed survey responses were received from the international MR-Linac Consortium from May to
September 2021. Among the respondents, the majority were based in Europe (65%), followed by North America (20%), Asia
(11%), Oceana (4%), and Latin America (1%). Of all respondents, 75 (74%) respondents provided MRgRT at their institution,
20 (20%) were in the process of technology installation, 2 (2%) considered technology acquirement and 5 (5%) were
unspecified.
The majority of respondents (61%) only understood the purpose cost-effectiveness analysis, 27% had no knowledge about it
and 12% indicated to fully understand it. Furthermore, 42% of all respondents indicated that the MR-Linac is being evaluated
on cost-effectiveness at their institution, 39% did not know and 19% indicated that such an evaluation was not being
performed. Of the 43 respondents evaluating cost-effectiveness, the majority (60%) lacked knowledge of the methodology
being applied or used scenario analysis, threshold analysis and/or decision analytical modelling. 54% of all respondents
perceived that demonstrating the cost-effectiveness is important for reimbursement, 28% do not know and 18% do not think so. The three most frequently mentioned reasons for not performing cost-effectiveness analysis were lack of human
resources (22%), lack of external incentive (19%) or funding (19%).
98% of all participants expected patient benefits and 62% perceived economic benefits from the MR-Linac over standard
treatment. While participants were optimistic towards technology benefits, also critical remarks were given regarding the
actual added value in the radiation oncology field, including technological complexities and the substantial staffing and
structural investments.
Conclusion
A substantial proportion of members of the MR-Linac Consortium has no or only limited knowledge about cost-effectiveness
analysis. While most participants claimed that demonstrating cost-effectiveness is important for reimbursement, the
majority had no knowledge on whether cost-effectiveness analysis was performed at their institutions or indicated that it
was not being performed. As a result, the opportunity to steer research and development within the MR-Linac Consortium
may not be optimally used. More and better understanding of cost-effectiveness is needed to improve the use and quality
of such analyses and the consortium.
| Original language | English |
|---|---|
| Pages (from-to) | S885-S886 |
| Journal | Radiotherapy and Oncology |
| Volume | 170 |
| Issue number | S1 |
| DOIs | |
| Publication status | Published - May 2022 |