EUROPEAN PAPERS ON THE NEW WELFARE

3.7 What Are the Costs of Proton Therapy?

We shall present here the costs of construction, equipping and running a PT center for 1,000 patients per year, and compare them to the corresponding costs of a conformal X-ray therapy center for the same number of patients per year¹⁶. In conformal X-ray therapy, additional attention is paid to conform the radiation field to the tumour volume more accurately than in standard X-ray therapy. In order to have 1,000 patients per year, the PT center should have one large accelerator, being a cyclotron or synchrotron, and three treatment rooms. Since one radiation oncologist can cover 150 patients per year, the center should have seven such physicians. As a result, the staff of the center ought to have 80 people, including the medical staff of 60 people.
The equipment of the PT center comprises the cyclotron or synchrotron, the equipment in the treatment rooms, and the additional medical equipment. The costs of purchasing all this equipment and of construction of the building of the center are estimated to be USD 29 million. The running costs of the center comprise the gross salaries of the staff, the costs of accomodation and transportation of the patients, the costs of amortization of the equipment, and the costs of maintenance. They are estimated to be USD 12.3 million per year. This means that the estimated costs of one treatment with protons are USD 12,300, i.e., about EUR 9,100. The corresponding price of one treatment may also include the amounts for returning the investment and making the profit.
The conformal X-ray therapy center for 1,000 patients per year should have three fully equipped linear electron accelerators. Its staff ought to be approximatelly the same as that of the PT center. The costs of purchasing the equipment and of construction of the building of the conformal X-ray therapy center are estimated to be USD 12.9 million, while its running costs are estimated to be USD 10.6 million. This means that the estimated costs of one conformal treatment with X-rays are USD 10,600, i.e., about EUR 7,900.
It is clear that the costs of one tumour treatment with protons and of one conformal tumour treatment with X-rays are comparable; the former costs are only 16% higher than the latter ones. The costs of one tumour treatment with protons should be also compared to the costs of other types of tumour treatments. In Europe, the costs of one tumour chemotherapy has been accepted to be USD 16,800, the costs of one tumour surgery USD 9,800, and the costs of one standard tumour X-ray therapy USD 4,200. Since these three types of treatments are often combined, with chemotherapy being the first, surgery the second and standard X-ray therapy the third, it is clear that such a combined treatment can be considerably more expensive than one treatment with protons.
It must be noted that in the case of a medium-sized cyclotron, which is used for PT of only shallow-seated tumours, such as eye tumours, the costs of one treatment are lower than the costs of one treatment with a large cyclotron or synchrotron, which is used for PT of deep-seated tumours, such as pelvis tumours. If the medium-sized cyclotron is a multi-purpose machine, the former costs can be even two times lower than the latter ones.

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