Innovation, value and reimbursement in radiation and complex surgical oncology: time to rethink

Background and purpose: Complex surgery and radiotherapy are the central pillars of loco-regional oncology treatment. This paper describes the reimbursement schemes used in radiation and complex surgical oncology, reports on literature and policy reviews. Material and methods: A systematic review of...

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Autores: Borràs Andrés, Josep Maria, Corral, Julieta, Aggarwal, Ajay, Audisio, Riccardo, Espinàs Piñol, Josep Alfons, Figueras, Josep, Naredi, Peter, Panteli, Dimitra, Pourel, Nicolas, Prades, Joan, Lievens, Yolande
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/186528
Acceso en línea:https://hdl.handle.net/2445/186528
Access Level:acceso abierto
Palabra clave:Radioteràpia
Cirurgia oncològica
Càncer
Tumors
Radiotherapy
Surgical oncology
Cancer
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spelling Innovation, value and reimbursement in radiation and complex surgical oncology: time to rethinkBorràs Andrés, Josep MariaCorral, JulietaAggarwal, AjayAudisio, RiccardoEspinàs Piñol, Josep AlfonsFigueras, JosepNaredi, PeterPanteli, DimitraPourel, NicolasPrades, JoanLievens, YolandeRadioteràpiaCirurgia oncològicaCàncerTumorsRadiotherapySurgical oncologyCancerTumorsBackground and purpose: Complex surgery and radiotherapy are the central pillars of loco-regional oncology treatment. This paper describes the reimbursement schemes used in radiation and complex surgical oncology, reports on literature and policy reviews. Material and methods: A systematic review of the literature of the reimbursement models has been carried out separately for radiotherapy and complex cancer surgery based on PRISMA guidelines. Using searches of PubMed and grey literature, we identified articles from scientific journals and reports published since 2000 on provider payment or reimbursement systems currently used in radiation oncology and complex cancer surgery, also including policy models. Results Most European health systems reimburse radiotherapy using a budget-based, fee-for-service or fraction-based system; while few reimburse services according to an episode-based model. Also, the reimbursement models for cancer surgery are mostly restricted to differences embedded in the DRG system and adjustments applied to the fees, based on the complexity of each surgical procedure. There is an enormous variability in reimbursement across countries, resulting in different incentives and different amounts paid for the same therapeutic strategy. Conclusion: A reimbursement policy, based on the episode of care as the basic payment unit, is advocated for. Innovation should be tackled in a two-tier approach: one defining the common criteria for reimbursement of proven evidence-based interventions; another for financing emerging innovation with uncertain definitive value. Relevant clinical and economic data, also collected real-life, should support reimbursement systems that mirror the actual cost of evidence-based practice.Elsevier2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/186528Articles publicats en revistes (Ciències Clíniques)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1016/j.ejso.2021.08.018European Journal of Surgical Oncology, 2022, vol. 48, num. 5, p. 967-977https://doi.org/10.1016/j.ejso.2021.08.018cc-by-nc-nd (c) Borràs, Josep M. et al., 2022https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1865282026-05-27T06:46:51Z
dc.title.none.fl_str_mv Innovation, value and reimbursement in radiation and complex surgical oncology: time to rethink
title Innovation, value and reimbursement in radiation and complex surgical oncology: time to rethink
spellingShingle Innovation, value and reimbursement in radiation and complex surgical oncology: time to rethink
Borràs Andrés, Josep Maria
Radioteràpia
Cirurgia oncològica
Càncer
Tumors
Radiotherapy
Surgical oncology
Cancer
Tumors
title_short Innovation, value and reimbursement in radiation and complex surgical oncology: time to rethink
title_full Innovation, value and reimbursement in radiation and complex surgical oncology: time to rethink
title_fullStr Innovation, value and reimbursement in radiation and complex surgical oncology: time to rethink
title_full_unstemmed Innovation, value and reimbursement in radiation and complex surgical oncology: time to rethink
title_sort Innovation, value and reimbursement in radiation and complex surgical oncology: time to rethink
dc.creator.none.fl_str_mv Borràs Andrés, Josep Maria
Corral, Julieta
Aggarwal, Ajay
Audisio, Riccardo
Espinàs Piñol, Josep Alfons
Figueras, Josep
Naredi, Peter
Panteli, Dimitra
Pourel, Nicolas
Prades, Joan
Lievens, Yolande
author Borràs Andrés, Josep Maria
author_facet Borràs Andrés, Josep Maria
Corral, Julieta
Aggarwal, Ajay
Audisio, Riccardo
Espinàs Piñol, Josep Alfons
Figueras, Josep
Naredi, Peter
Panteli, Dimitra
Pourel, Nicolas
Prades, Joan
Lievens, Yolande
author_role author
author2 Corral, Julieta
Aggarwal, Ajay
Audisio, Riccardo
Espinàs Piñol, Josep Alfons
Figueras, Josep
Naredi, Peter
Panteli, Dimitra
Pourel, Nicolas
Prades, Joan
Lievens, Yolande
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Radioteràpia
Cirurgia oncològica
Càncer
Tumors
Radiotherapy
Surgical oncology
Cancer
Tumors
topic Radioteràpia
Cirurgia oncològica
Càncer
Tumors
Radiotherapy
Surgical oncology
Cancer
Tumors
description Background and purpose: Complex surgery and radiotherapy are the central pillars of loco-regional oncology treatment. This paper describes the reimbursement schemes used in radiation and complex surgical oncology, reports on literature and policy reviews. Material and methods: A systematic review of the literature of the reimbursement models has been carried out separately for radiotherapy and complex cancer surgery based on PRISMA guidelines. Using searches of PubMed and grey literature, we identified articles from scientific journals and reports published since 2000 on provider payment or reimbursement systems currently used in radiation oncology and complex cancer surgery, also including policy models. Results Most European health systems reimburse radiotherapy using a budget-based, fee-for-service or fraction-based system; while few reimburse services according to an episode-based model. Also, the reimbursement models for cancer surgery are mostly restricted to differences embedded in the DRG system and adjustments applied to the fees, based on the complexity of each surgical procedure. There is an enormous variability in reimbursement across countries, resulting in different incentives and different amounts paid for the same therapeutic strategy. Conclusion: A reimbursement policy, based on the episode of care as the basic payment unit, is advocated for. Innovation should be tackled in a two-tier approach: one defining the common criteria for reimbursement of proven evidence-based interventions; another for financing emerging innovation with uncertain definitive value. Relevant clinical and economic data, also collected real-life, should support reimbursement systems that mirror the actual cost of evidence-based practice.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/186528
url https://hdl.handle.net/2445/186528
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.ejso.2021.08.018
European Journal of Surgical Oncology, 2022, vol. 48, num. 5, p. 967-977
https://doi.org/10.1016/j.ejso.2021.08.018
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Borràs, Josep M. et al., 2022
https://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Borràs, Josep M. et al., 2022
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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