INTRODUCTION There is a steady rise in Stereotactic Body RadioTherapy (SBRT) utilization in oligometastatic disease (OMD). This may generate important financial consequences for radiotherapy budgets. The National Institute for Health and Disability Insurance of Belgium (NIHDI) initiated a coverage with evidence development (CED) project for innovative radiotherapy, including SBRT, in 2011. A cost calculation and budget estimation for SBRT in the OMD setting was carried out. MATERIALS AND METHODS Predictive growth scenarios for future uptake of SBRT for OMD in Belgium were developed using demographics and CED data. The provider cost of SBRT for OMD in Belgium was calculated using the Time-Driven Activity-Based Costing (TD-ABC) model developed by ESTRO-HERO, alimented with national data on resources, treatments and operational parameters, and compared to the new reimbursement. Combining these, the future financial impact of this novel treatment indication for healthcare providers and payers in Belgium was evaluated. RESULTS The number of 428 OMDs treated with SBRT in Belgium in 2017 is expected to increase between 484 and 2073 courses annually by 2025. A provider cost of €4360 per SBRT was calculated (range: €3488-€5654), whereas the reimbursement covers between €4139 and €4654. Large variations in potential extra provider costs by 2025 ensue from the different scenarios, ranging between €1,765,993 and €9,038,754. Provider costs and reimbursement show good agreement. CONCLUSION Although the financial impact of SBRT for OMD in Belgium is forecasted to remain acceptable, even in extreme scenarios, further clinical trials and real-life clinical and financial monitoring with prospective data gathering are necessary to refine the data.

中文翻译：

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SBRT 对寡转移疾病的财务影响：比利时的人口水平分析

引言 立体定向放射治疗 (SBRT) 在寡转移性疾病 (OMD) 中的应用稳步上升。这可能会对放射治疗预算产生重要的财务影响。比利时国家健康和残疾保险研究所 (NIHDI) 于 2011 年启动了包括 SBRT 在内的创新放射治疗的证据开发覆盖 (CED) 项目。对 OMD 环境中的 SBRT 进行了成本计算和预算估算。材料和方法 使用人口统计数据和 CED 数据开发了比利时 OMD 未来采用 SBRT 的预测增长情景。比利时 OMD 的 SBRT 提供者成本是使用 ESTRO-HERO 开发的基于时间驱动的活动成本法 (TD-ABC) 模型计算的，并辅以有关资源、治疗和操作参数的国家数据，并与新的报销相比。结合这些，评估了这种新型治疗适应症对比利时医疗保健提供者和付款人的未来财务影响。结果 2017 年比利时接受 SBRT 治疗的 428 名 OMD 的数量预计到 2025 年每年将增加 484 至 2073 门课程。计算出每个 SBRT 的提供者成本为 4360 欧元（范围：3488 欧元至 5654 欧元），而报销涵盖4139 欧元到 4654 欧元之间。到 2025 年，不同情况下潜在的额外供应商成本会有很大差异，从 1,765,993 欧元到 9,038,754 欧元不等。提供者成本和报销表现出良好的一致性。结论 尽管 SBRT 对比利时 OMD 的财务影响预计仍然可以接受，即使在极端情况下，