OBJECTIVES: Establishing and maintaining gamma knife facility incurs significant costs, mandating healthcare institutions to meticulously assess financial implications for sustainability. Hence, this study was carried out with an aim of identifying various cost centres for estimating the cost of establishing and maintaining a gamma knife facility with a focus on determining the user charges required to achieve breakeven analysis.

METHODS: An exploratory study was conducted in the Gamma Knife Facility of the largest Neurosciences Centre of India located in an Institute of National Importance from Jan to June 2019 which included process analysis, interaction with concerned stakeholders and retrospective record review for ascertaining resource consumption. Applying both Traditional and Time-Driven Activity-Based Costing (TD-ABC) methodologies, capital and operating expenses were calculated. Thereafter the cost per GKRS procedure and various cost analysis for establishing as well as achieving breakeven were calculated. (1US$ = INR 70.4 – Average value for the year 2019)

RESULTS: The average cost per gamma knife radio surgery procedure was calculated to be US $2,469 ( INR 1,73,832), with major costs attributed to machinery & equipment (43.6%), followed by manpower (32.5%), electricity (9.67%), equipment maintenance (8.61%) etc. The initial investment to establish a Gamma Knife facility is significantly higher with an MRI unit (Model A) at US $ 9,836,423 (INR 69,24,84,164 ) compared to one without (Model B) at US $7,294,986 (INR 51,35,66,988). Currently, the patient has to pay US $1,065 (INR 75,000) for a gamma knife radio surgery, which poses a challenge for achieving breakeven since the variable cost for the same is US $1,367 (INR 96,239) per procedure.

CONCLUSIONS: The study serve as a tool for strategic planning, pricing adjustments, and enhancing operational efficiencies, thus ensuring that such high-end technologies can be sustainably integrated into the public healthcare landscape of a developing country like India.