The nature of radioactive decay means that the administration of medical interventions that utilize radionuclides is time sensitive and requires careful planning. For techniques such as selective internal radiation therapy (SIRT), pre-treatment work-up procedures are also required to assess the vascular anatomy of the liver, potentially occlude certain hepatic blood vessels, and establish the hepatopulmonary shunt fraction. The aim of the present study was to evaluate the effect of the SIR-Spheres Y-90 resin microspheres FLEXdose and Order-Map-Treat radionuclide delivery and procedure planning programs on the cost of performing SIRT.

The effects of the FLEXdose and Order-Map-Treat programs on costs were evaluated from the perspective of the UK Department of Health (DoH). The FLEXdose program allows for delivery of SIR-Spheres Y-90 resin microspheres at multiple timepoints prior to the planned treatment, while the complementary Order-Map-Treat program enables both the work-up and procedure to be performed on the same day. Costs of work-up and treatment were calculated based on 2018-19 NHS Reference Costs, and the cost reduction was assumed to arise from the avoidance of one day case admission per patient treated with SIRT.

Assuming the complementary FLEXdose and Order-Map-Treat programs would together enable work-up and treatment to be performed in a single day, the anticipated cost savings relative to administering SIR-Spheres Y-90 resin microspheres without the two programs would be GBP 2,619 per patient, corresponding to a cost reduction of 19.8% from GBP 13,237 to GBP 10,619 per patient treated.

The present analysis showed that the FLEXdose and Order-Map-Treat programs would result in cost savings from the UK DoH perspective versus performing SIRT without either of the programs. The additional flexibility afforded by the FLEXdose and Order-Map-Treat programs may also increase flexibility of interventional radiology suite scheduling, which may in turn bring about benefits beyond cost alone.