Optimizing the Reimbursement for Brachytherapy: A Critical Factor in Controlling Total Healthcare Expenditure for Prostate Cancer in Italy

This research, conducted at Elekta in Veenendaal, a leading manufacturer of radiation therapy solutions and a leading provider of brachytherapy solutions, aims to address the underutilization of brachytherapy for prostate cancer treatment in Italy compared to its alternatives, with a particular emphasis on its significant disparity with Spain where it is at least 40% less utilized. We identify inadequate reimbursement as a key contributing factor to this discrepancy. Therefore, our research aim is to find an optimal reimbursement rate for brachytherapy in Italy by demonstrating its clinical benefits and cost-effectiveness compared to alternatives. To achieve this, we developed a patient distribution model to simulate the allocation of patients among prostate cancer treatment modalities and a Markov model for prostate cancer with a 6-year time horizon and a 1-year cycle length to evaluate the economic value of brachytherapy and its alternatives. Alongside cost-effectiveness analysis, the model can perform a budget impact analysis to determine the optimal reimbursement rate, ensuring cost-effectiveness and minimal overall expenditure. Our findings indicate that brachytherapy outperforms alternatives in terms of effectiveness, advocating a higher reimbursement to encourage its wider adoption among patients. The model is adaptable and can be applied to various diseases, especially cancer. It serves as a valuable tool for healthcare decision-makers, allowing them to compare treatment options and decide on optimal reimbursement rates. This makes the model a powerful tool in healthcare decision-making, offering insights for improving patient care and resource management.