Original ArticleNational costs and resource requirements of external beam radiotherapy: A time-driven activity-based costing model from the ESTRO-HERO project
Section snippets
Material and methods
Activity-based costing (ABC) is a cost-accounting method developed to allocate indirect costs to products when resource consumption is not volume-driven [11]. It allocates resource costs to products through the activities performed in the production process. TD-ABC [12], [13], an advanced form of ABC, uses time as the unique driver of resource utilization and allocates in one composite step [14]. Besides cost estimates, it also provides insight into resource requirements using two different
Results
While the costing model is primarily developed to estimate the costs and resource requirements of EBRT, it is well-recognized that activities beyond the strict EBRT care-pathway are necessary to provide a complete, qualitative and safe radiation oncology (RO) programme. To account for these diverse levels, the model has been developed in three layers: EBRT-Core, RO-Support and Beyond-EBRT (Fig. 1a and b).
The central layer follows the TD-ABC methodology and provides insight into the EBRT-Core
Discussion
In times of budget scarcity, increasing attention is paid to economic evidence. While literature data on actual EBRT costs and on the financial impact of different radiotherapy innovations remain scarce [10], the European NS-RO reported that this type of information is crucial when negotiating for optimal access to and reimbursement of radiotherapy. To help closing this evidence gap, a TD-ABC model for EBRT, suitable for national implementation and available as a web-based tool, has been
Declaration of Competing Interest
The authors have no conflict of interest to declare.
Acknowledgements
This work has been performed in the framework of the Health Economics in Radiation Oncology project, initiated and financially supported by the European Society for Radiotherapy and Oncology. ESTRO did not intervene in the execution of this analysis, nor in the writing of the manuscript.
We thank Peter Dunscombe (Deceased Emeritus Professor, University of Calgary, Canada) for his contribution to this research and Chiara Gasparotto (Director for Policy and Partnerships) for her support and
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