SYSTEMATIC LITERATURE REVIEW OF PARTICLE THERAPY COSTING: TWO DECADES OF EVIDENCE ON COSTING METHODS AND ANALYTICAL ASSUMPTIONS
Author(s)
Yaqeen Shanti, MASc1, Sophie Hoozée, PhD2, Delphine De Smedt, PhD3, Barbara Vanderstraeten, PhD1, Yolande Lievens, PhD1.
1Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium, 2Faculty of Economics and Business Administration, University of Ghent, Ghent, Belgium, 3Ghent University, Gent, Belgium.
1Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium, 2Faculty of Economics and Business Administration, University of Ghent, Ghent, Belgium, 3Ghent University, Gent, Belgium.
OBJECTIVES: Particle therapy (PT) is an advanced type of radiotherapy requiring substantial investment and operational costs. Robust economic evaluations are essential to inform reimbursement and adoption decisions, yet there is currently no standardised approach for estimating PT costs. This systematic literature review evaluates the methods used and analytical assumptions applied in costing studies of PT, to inform recommendations for a standardised costing framework in radiotherapy.
METHODS: A systematic search was conducted across four databases to identify relevant costing studies, with data extraction focusing primarily on the structure and content of the analyses. Cost items were re-categorised based on accountancy principles when applicable depending on the costing method applied. Methodological quality was assessed using an adapted CHEERS checklist for costing analyses.
RESULTS: From 2,334 records, 12 studies met inclusion criteria. While methodological quality was generally high, considerable heterogeneity was observed. Time-Driven Activity-Based Costing (TD-ABC) studies (n=4) categorised cost items as direct costs (resource costs directly traceable to cost objects without allocation) or indirect costs (shared resources requiring allocation). Despite using same method, studies differed in allocation bases and included cost items. Seven studies used traditional costing, with allocation based on patient numbers, fractions, or room time. Cost item inclusion varied widely, from limited operational costs to detailed list of cost items. One study used discounted cash-flow analysis for investment evaluation without cost allocation. Based on these findings, recommendations are proposed for PT costing, including selecting the costing method that captures the required level of detail, defining cost items which reflect actual costs, and using transparent allocation bases. Finally, the cost object should align with the objectives of the analysis.
CONCLUSIONS: The findings highlight the gap in costing practices in PT. The Recommendations proposed, still needs further consensus to be implemented as standardised guidelines. Alongside development of a dedicated quality assessment checklist for costing studies.
METHODS: A systematic search was conducted across four databases to identify relevant costing studies, with data extraction focusing primarily on the structure and content of the analyses. Cost items were re-categorised based on accountancy principles when applicable depending on the costing method applied. Methodological quality was assessed using an adapted CHEERS checklist for costing analyses.
RESULTS: From 2,334 records, 12 studies met inclusion criteria. While methodological quality was generally high, considerable heterogeneity was observed. Time-Driven Activity-Based Costing (TD-ABC) studies (n=4) categorised cost items as direct costs (resource costs directly traceable to cost objects without allocation) or indirect costs (shared resources requiring allocation). Despite using same method, studies differed in allocation bases and included cost items. Seven studies used traditional costing, with allocation based on patient numbers, fractions, or room time. Cost item inclusion varied widely, from limited operational costs to detailed list of cost items. One study used discounted cash-flow analysis for investment evaluation without cost allocation. Based on these findings, recommendations are proposed for PT costing, including selecting the costing method that captures the required level of detail, defining cost items which reflect actual costs, and using transparent allocation bases. Finally, the cost object should align with the objectives of the analysis.
CONCLUSIONS: The findings highlight the gap in costing practices in PT. The Recommendations proposed, still needs further consensus to be implemented as standardised guidelines. Alongside development of a dedicated quality assessment checklist for costing studies.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE99
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology