Authors' objectives:

The purpose of this study is to provide economic information to decision makers in Alberta Health and Wellness about the treatment alternatives for neurosurgical patients requiring stereotactic radiosurgery (SRS). The aim of this report is to provide cost estimates for the three main SRS technologies: Gamma Knife (GK), CyberKnife (CK) and LINAC (Novalis(R)). Cost factors are estimated and valued based on provincial data, as available.

Authors' recommendations: This study shows that there is no significant difference between the costs of dedicated GK and Novalis(R) units in Alberta. A CK unit seems to be significantly more expensive than the other two alternatives. The current volume of patients in Alberta predicted to be appropriate for SRS is in the range of 100 to 185 patients per year. This number does not include patients who may be referred for SRS from Saskatchewan, British Columbia, and the Northwest Territories. According to this model, if a 0% interest rate were used and 100 patients per year were treated, the average cost per patient would be 14,567 dollars for GK, 14,889 dollars for Novalis(R), and 16,690 dollars for CK. When taking into account the out-of-province travel, hotel expenses and lost earnings for both the patient and caregiver (estimated to be 1,600 dollars) as well as the estimated cost of the procedure (15,000 dollars) it appears that the option of establishing a dedicated unit in Alberta should be considered. From a patient's perspective the SRS technology, where appropriate, is about one sixth of the cost of microsurgery. In the fractionated SRT treatment the cost for the patient and caregiver are significantly higher than for a single SRS treatment. If the costs were calculated from the societal perspective including both direct medical costs and indirect patient costs, the Novalis and GK would be cost saving even at a level of 100 patients per year. However, at that operational level, health care resources would not be efficiently used due to excess capacity of the SRS team and of equipment. Central to the decision concerning SRS in Alberta and Western Canada is the fact that Manitoba will have a GK based SRS unit operationalized sometime in 2003 and Quebec is considering the prospect of a dedicated SRS unit. If Alberta were to invest in a dedicated SRS unit, there is a question as to whether there would be enough of a workload for the Alberta unit, the one in Manitoba, and the other potential unit in Quebec. The field of SRS is changing rapidly (e.g. for functional neurosurgical patients) which makes the projection of the number of Canadian patients very difficult.

Authors' methods: Cost study

Project Status: Completed

Year Published: 2003

URL for published report: https://www.ihe.ca/advanced-search?type=1020

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute of Health Economics

Contact Address: 1200, 10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4. Tel: +1 780 448 4881; Fax: +1 780 448 0018;

Contact Name: djuzwishin@ihe.ca

Contact Email: djuzwishin@ihe.ca

Copyright: <p>Alberta Heritage Foundation for Medical Research (AHFMR)</p>