Health Economic Modelling – Proton Therapy

8th December 2022

Two thirds of cancer treatment regimens in developed nations use radiotherapy, which can be divided into:

  • Proton therapy, which deposits minimal energy through normal cells, with an increasing dose targeted towards cancer cells
  • Photon therapy, a highly penetrating beam that targets cancer cells and surrounding normal cells

The NHS Long Term Plan aims to save the lives of thousands of cancer patients by improving cancer diagnosis and treatment. Current forms of radiotherapy in the NHS require long construction times and take up great amounts of space. There is currently a cancer therapy backlog in the NHS, which was worsened by the coronavirus pandemic. Therefore, finding new ways of reducing this backlog is essential to prevent and manage patient deterioration.

Leo Cancer Care created MarieTM (Figure 1), an upright proton beam therapy (PBT) cancer treatment. Unity Insights was commissioned by Kent, Surrey, Sussex (KSS) AHSN and Leo Cancer Care to evaluate whether MarieTM would be suitable within the NHS PBT cancer treatment pathway. A validation report, cost-benefit analysis, budget impact model, and a final evaluation report was delivered to determine this.

Figure 1. Leo Cancer Care's Marie.

The validation report indicated that current NHS radiotherapy treatment was costly and time consuming, where a backlog of cancer patients resulted in prioritisation of patients by the severity of their cancer. Leo Cancer Care’s MarieTM treats patients in the upright position, leading to faster set up times. Further, the equipment used to build MarieTM was designed to lower costs. Although this suggests MarieTM would be a suitable addition within the NHS cancer treatment pathway, limited research is available to back up these claims.

The cost-benefit analysis calculated that the return on investment (ROI) for the NHS averaged at £0.61 for every £1 spent, and the ROI for Leo Cancer Care averaged at £0.91 for every £1 spent between years 2 and 20. In this case, Leo Cancer Care was suggested to yield a greater ROI compared to existing NHS machines. A budget impact model was developed to allow Leo Cancer Care to identify the efficiencies of using their own equipment, compared to existing NHS equipment, to treat cancer patients. The model allowed users to input their own, or desired values, to understand the potential impact.

The final evaluation report concluded that Leo Cancer Care’s MarieTM appeared to yield lower costs compared to NHS machines, complementing the validation report produced. It was suggested that there was need for more research into MarieTM to build an evidence base that backs up the claims made by Leo Cancer Care. From this, the NHS may decide to use MarieTM when building further PBT treatment sites to lower the backlog of patients whilst yielding cost savings.


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