Cost-effectiveness of proton radiotherapy versus photon radiotherapy for non-small cell lung cancer patients: Exploring the model-based approach.
Published in the Green Journal, this study compared costs and QALYs of three treatment strategies for patients with stage III NSCLC including 1. photon radiotherapy for all patients (XRTAll); 2. PT for all patients (PTAll); 3. PT for selected patients (PTIndividualized). Dyspnea, dysphagia and cardiotoxicity were the toxicities included in the model calculation. Costs and QALY's were incorporated for grade 2 and ≥3 toxicities separately. Incremental Cost-Effectiveness Ratios (ICERs) were compared to a threshold value of €80,000. This study reported that PTAll yielded most QALYs but was also most expensive. PT is not cost-effective for all patients, nor for patient selected on the current NTCP models used in the Dutch indication protocol. XRTAll was the least effective and least expensive strategy, and the most cost-effective strategy. When assuming equal minutes per fraction (15 minutes) for PT and XRT, PTIndividualized was considered the most cost-effective strategy (ICER: €76,299).