A roadmap and cost implications of establishing comprehensive cancer care using a teleradiotherapy network in a group of sub-Saharan African countries with no access to radiotherapy

Publication date: Available online 29 March 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Niloy R. Datta, Michael Heuser, Stephan Bodis
PurposeTo propose a roadmap and explore the cost implications of establishing a teleradiotherapy network to provide comprehensive cancer care and capacity building in countries without access to radiation therapy.Methods and MaterialsTen low-income sub-Saharan countries with no current radiotherapy facilities were evaluated. A basic/secondary radiotherapy center (SRTC) with two teletherapy, one brachytherapy, one simulator and a treatment planning facility was envisaged at a cost of USD 5M. This could be networked with one to four primary radiotherapy centers (PRTC) with one teletherapy unit, each costing USD 2M. The numbers of PRTCs and SRTCs for each country were computed based on cancer incidence, assuming that a PRTC and SRTC could respectively treat 450 and 900 patients annually.ResultsAn estimated 71215 patients in these countries will need radiotherapy in 2020. Step-wise establishment of a network with 99 PRTCs and 28 SRTCs would result in 155 teletherapy units and 96% access to radiotherapy. 310 radiation oncologists, 155 medical physicists and 465 radiotherapy technologists would be needed. Capacity building could be undertaken through telementoring by networking to various international institutions and professional societies. Total infrastructure costs would be around USD 860.88M, only 0.94% of the average annual GDP of these 10 countries. 1.04 million patients could receive RT during the 15 year lifespan of a teletherapy unit for an investment of USD 826.69/patient. For the entire population of 218.32 million, this equates to USD 4.11 per inhabitant.ConclusionA teleradiotherapy network could be a cost-contained innovative healthcare strategy to provide effective comprehensive cancer care through resource sharing and capacity building. The network could also be expanded to include other allied specialties. The proposal calls for active coordination between all national and international organizations backed up by strong geopolitical commitment and action from all stakeholders.

Teaser

A roadmap, along with cost implications, of developing a teleradiotherapy network for comprehensive cancer care was examined in 10 sub-Saharan countries, with no radiotherapy facilities. An investment of USD 860.88 million (0.94% of average annual GDP) could provide 96% access to radiotherapy and support capacity building. The facility could treat 1.05 million patients over 15 years at an average cost of USD 826.70/patient. This benefits 218.32 million inhabitants at an investment of USD 4.11/inhabitant.


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