An economic framework for evaluating a multileaf collimator

Objectives: As health care budgets continue to face close scrutiny, any new acquisition must be evaluated for both costs and outcomes. This study was undertaken to demonstrate the application of an economic framework for the evaluation of a multileaf collimator as an example of a new technology that can have both quantifiable and nonquantifiable benefits for patients, staf f, and cancer care institutions. Methods: Using financial data from the Northeastern Ontario Regional Cancer Centre (NEORCC) and a recognized staffing model, a commercial spreadsheet, developed to economically characterize the principal radiotherapy processe s has been used to determine the net incremental annual cost of a multileaf collimator (MLC). Results: The incremental annual cost of purchasing an MLC is estimated at a pproximately $85,000 (1997 CDN $). Without increasing patient throughput, t his increases the average cost of a course of radiotherapy by approximately CDN $200. Savings can be accrued by decreasing mold room activity, increas ing the hourly patient capacity on each treatment machine, and decreasing s ick time due to strain injuries. Conclusions: Although the clinical outcome of techniques facilitated by MLC s, such as intensity-modulated radiation therapy, are unknown at this time, an economic context within which to objectively evaluate this technology i s presented. The framework presented suggests a method of quantifying outco me-justified expenditures, such as improved patient outcome and greater tre atment flexibility, which, when offset against the incremental annual equip ment cost. may be used to help justify the acquisition of multileaf technol ogy.