Author: Xinyuan Chen 👨🔬
Affiliation: Washington University School of Medicine 🌍
Purpose: This study evaluates the financial viability of on-table simulation (CBCTp) enabled Halcyon system in radiation therapy. By leveraging Time-Driven Activity-Based Costing (TDABC), the analysis assesses three utilization scenarios: (1) a single Halcyon machine, (2) a Halcyon machine with an additional CT simulator, and (3) a Halcyon machine combined with a TrueBeam system.
Methods: The study collected data on patient population, machine costs, and operational expenses from clinical experiences. TDABC was used to calculate the net revenue under varying treatment and simulation times. A simulation framework modeled patient scheduling, treatment workflows, and revenue outcomes over a 10-year period, incorporating ±20% variations in treatment and simulation times to reflect diverse clinical workflows.
Results: A single Halcyon machine could efficiently handle up to two new-sim patients daily while maintaining positive net revenue. A 20% reduction in treatment time increased capacity to three new-sim patients. Adding a CT simulator improved capacity to three patients with consistent net revenue, while combining a TrueBeam system enabled up to four new-sim patients. However, the latter scenario incurred additional costs, resulting in negative net revenue unless patient volumes exceeded two new-sim patients per day.
Conclusion: The Halcyon system offers a financially viable solution for integrating on-table simulation into radiation therapy workflows, particularly when standalone CT simulators are unavailable. Adding a CT simulator or a second treatment unit enhances patient capacity but requires higher patient volumes for cost-effectiveness. These findings underscore the importance of aligning technology utilization with patient demand and clinic workflows to achieve sustainable financial performance in radiation oncology.