Radiology Oncology Systems (ROS) of San Diego has released results from a survey taken in October 2015 related to radiation therapy in veterinary medicine.
Radiation therapy is becoming increasingly important in animal patient care, since nearly 50 percent of dogs over the age of ten will die of cancer, according to the National Canine Cancer Foundation (NCCF). Additionally, nearly 60 percent of all human cancer patients have radiation therapy included as part of their treatment plan.
Of the respondents to the ROS survey, 67.5 percent were already currently performing radiation therapy, and of the remaining 32.5 percent of respondents, the majority (69.2 percent) indicated that radiation therapy was in fact something they were considering in the future. Reasons cited for wanting to add radiation therapy included the need to treat cancer for a growing patient population.
The majority of radiation therapy centers surveyed (60 percent) were treating in excess of 100 patients per year. Most of the patients being treated with radiation therapy are dogs (70–80 percent), followed by cats, which account for 20–30 percent of those animals being treated.
Of the respondents performing radiation therapy, all four major linear accelerator manufacturers were represented in the survey (Varian, Elekta, Accuray (Tomotherapy), and Siemens), with equipment ranging from older to newer systems (e.g., Varian Trilogy). One facility was still using a cobalt system but was migrating to a linear accelerator system.
Various treatment planning systems are currently used in veterinary radiation therapy, with Varian Eclipse as the leading system (33.3 percent), followed by Phillips’ Pinnacle (16.6) and Prowess’ Puma (12.5). Most centers do their own treatment planning (70.8 percent), with 20.8 percent citing that they will occasionally outsource treatment planning services. Under 10 percent of respondents outsource all of their treatment planning.
Some centers are offering advanced radiation therapy treatments—including SBRT (stereotactic body radiation therapy)—which reduces the number of times a patient must be anaesthetized during the treatment cycle, an important consideration with elderly and infirm animals.
Fewer than 15 percent of respondents performing radiation therapy stated that their centers are not performing well financially. Included in this group are centers using linear accelerators from local hospitals. The majority of respondents claimed that they are average to above average in return on investment, despite the high costs of equipment.
According to John Vano, president of ROS, the start-up costs of a radiation therapy veterinarian practice include the building of a radiation-shielded vault ($400,000+), a refurbished linear accelerator system and treatment planning software ($300,000+), and service and support costs and the technical staff (including medical physicists) needed to operate the system.
Although prices charged to patients varied based on geography, type of treatment, and type of equipment, the average basic (conformal) series of radiating therapy was around $5,000 per patient. Costs of maintaining the equipment, the treatment planning system, and the physics support were cited as reasons for higher prices.
When asked the biggest challenge for the practice, responses included managing patient throughput, insurance/reimbursement for patients, and the need to upgrade existing equipment. Other responses included balancing the cost of treatment with a low case load, and educating the pet-owning population on radiation treatment as an option.
The survey was conducted by Radiology Oncology Systems of San Diego, CA. See results here.
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