Using Economic Evaluation for Investment Decisions in Health Infrastructure in Catalonia

OBJECTIVES: In 2021, the Catalan Department of Health committed to investing in healthcare infrastructure to install two Proton Therapy machines at the Proton Therapy Centre of Catalonia (CPCT), located in Parc Sanitari Pere Virgili. The objective is to conduct an ex ante evaluation of the efficiency of this investment compared to conventional radiotherapy for treating patients.

METHODS: We performed cost-benefit and cost-utility analyses of the CPCT investment for patients with ocular tumors, skull base cancer, and central nervous system cancer. The analysis adopts the perspective of the Regional Health System over a 20-year time horizon. Costs are expressed in € 2023, and health benefits are measured in savings from CPCT-treated patients and quality-adjusted life years (QALYs). Univariate and multivariate deterministic sensitivity analyses were conducted.

RESULTS: The incremental cost-benefit ratio ranged between €1.29 and €1.56, indicating profitability of the CPCT investment. The cost-utility analysis also showed a dominant incremental cost-utility ratio.

CONCLUSIONS: Our analysis demonstrates the profitability of investing in the CPCT, projecting that it will yield more benefits than costs for patients and the Regional Health System. We recommend subjecting this infrastructure investment to ex-post evaluation to assess its efficiency once patients eligible for this technology begin treatment.