Purpose: The study comparatively analysed the cost-effectiveness of 25-fraction versus 5 fraction radiotherapy regimens for treating early breast cancer patients. Several clinical trials have been conducted to study the efficacy and safety of newer 5- fraction radiotherapy and compared them with conventional 25-fraction regimens.

Materials and methods: Health outcomes were estimated based on previously published randomized clinical trials (RCTs). Patients data are extracted from ARIA software, also observations and clinicians consultation. Time-driven activity-based costing (TDABC) was applied to estimate the hospital costs (direct fixed cost of radiotherapy and direct variable cost). The insurance tariff was calculated based on tax points and the society cost was defined as productivity loss (e.g., absence from work).

Results: The study found that 5-fraction regimens resulted in a total of 62% reductions of 62% for hospital costs, 51% for insurance and 93% for society. The RCTs examined the clinical outcomes and showed that 5-fraction regimens are not significantly different for normal tissue effect (NTE) and tumor recurrence compared with 25-fraction regimens according to their predefined objectives.

Conclusion: 5-fraction radiotherapy regimens demonstrated to be less costly than conventional 25-fraction regimens. More studies should be conducted to define the optimal treatment strategy and willingness to pay for the health benefits.

Possible real-life impact: In recent years, healthcare was developed and expenditure constantly increased in Switzerland, reaching around 12% of the gross domestic product (GDP), making it one of the world's priciest healthcare systems after only the United States. The system's transition requires a detailed understanding of healthcare costs encompassing transparent reporting of outcomes upon individual assumptions.

Keywords: Breast cancer; Radiotherapy; Cost-effectiveness; Time-driven activity-based costing; Hypofractionation