A national survey of HDR source knowledge among practicing radiation oncologists and residents: Establishing a willingness-to-pay threshold for cobalt-60 usage Journal Article

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Authors: Mailhot Vega, R.; Talcott, W; Ishaq, O.; Cohen, P.; Small, C. J.; Duckworth, T; Sarria Bardales, G.; Perez, C. A.; Schiff, P. B.; Small, W., Jr; Harkenrider, M. M.
Article Title: A national survey of HDR source knowledge among practicing radiation oncologists and residents: Establishing a willingness-to-pay threshold for cobalt-60 usage
Abstract: PURPOSE: Ir-192 is the predominant source for high-dose-rate (HDR) brachytherapy in United States markets. Co-60, with longer half-life and fewer source exchanges, has piloted abroad with comparable clinical dosimetry but increased shielding requirements. We sought to identify practitioner knowledge of Co-60 and establish acceptable willingness-to-pay (WTP) thresholds for additional shielding requirements for use in future cost-benefit analysis. METHODS AND MATERIALS: A nationwide survey of U.S. radiation oncologists was conducted from June to July 2015, assessing knowledge of HDR sources, brachytherapy unit shielding, and factors that may influence source-selection decision-making. Self-identified decision makers in radiotherapy equipment purchase and acquisition were asked their WTP on shielding should a more cost-effective source become available. RESULTS: Four hundred forty surveys were completed and included. Forty-four percent were ABS members. Twenty percent of respondents identified Co-60 as an HDR source. Respondents who identified Co-60 were significantly more likely to be ABS members, have attended a national brachytherapy conference, and be involved in brachytherapy selection. Sixty-six percent of self-identified decision makers stated that their facility would switch to a more cost-effective source than Ir-192, if available. Cost and experience were the most common reasons provided for not switching. The most common WTP value selected by respondents was lt;$25,000. CONCLUSIONS: A majority of respondents were unaware of Co-60 as a commercially available HDR source. This investigation was novel in directly assessing decision makers to establish WTP for shielding costs that source change to Co-60 may require. These results will be used to establish WTP threshold for future cost-benefit analysis.
Journal Title: Brachytherapy
ISSN: 1873-1449; 1538-4721
Publisher: Unknown  
Journal Place: United States
Date Published: 2017
Language: eng
DOI/URL:

S1538-4721(17)30323-9
Notes: LR: 20170519; CI: Copyright (c) 2017; JID: 101137600; OTO: NOTNLM; 2017/01/13 [received]; 2017/03/23 [revised]; 2017/04/13 [accepted]; aheadofprint