Health Economics in Radiation Oncology


The economics of health care is an increasingly important topic with competing demands on limited financial resources and the need to demonstrate cost effectiveness and value in order to secure limited resources. Radiation oncology has lagged behind other clinical specialties in collecting and analysing the data needed to influence governments and other health care funders which ultimately affects the care of patients. The HERO project, Health Economics in Radiation Oncology, aims to address this issue.

Launched in 2010, the HERO project has the overall aim to develop a knowledge base and a model for health economic evaluation of radiation treatments at the European level. To accomplish these objectives, the HERO project addresses different dimensions: the provision and accessibility of radiotherapy in Europe will be compared to the need for radiotherapy. Using these data, it is the aim to develop a cost-accounting program for radiotherapy at the European level and to engage in economic evaluations of radiotherapy, e.g. cost-effectiveness and cost-utility.

The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field.


Press review


Radiotherapy equipment and departments in the European countries: Final results from the ESTRO-HERO survey. Read the article >>>

Radiotherapy staffing in the European countries: Final results from the ESTRO-HERO survey. Read the article >>>

Guidelines for equipment and staffing of radiotherapy facilities in the European countries: Final results of the ESTRO-HERO survey. Read the article >>>

The optimal utilization proportion of external beam radiotherapy in European countries: An ESTRO-HERO analysis. Read the article >>>

The impact of cancer incidence and stage on optimal utilization of radiotherapy: Methodology of a population based analysis by the ESTRO-HERO project. Read the article  >>>

Radiotherapy capacity across Europe: What it should be, and what it is  (Cancer World, September-October 2013, issue 56) Read the article >>>



The need for radiotherapy

The project will help to define an optimum for radiotherapy in Europe to:

  • Conduct an evidence-based survey of the need for radiotherapy in Europe (e.g. “number of treatments per year”, “fractions per year”) based on cancer epidemiology within different European countries;
  • Describe models for estimated resources (infrastructure, equipment, personnel) required to deliver this optimum of care.

Provision and accessibility of radiotherapy

The aim is to assess the actual status of radiotherapy in Europe through a web-based information/documentation centre  for members and national societies on the:

  • Available guidelines regarding RO provision within different European countries;
  • Actual levels of RO infrastructure, equipment and staffing in different European countries;
  • Actual treatments delivered on an annual basis per country.

Cost-accounting programme for RO

The development of a cost-accounting computer programme for RO in Europe will allow users to:

  • Calculate cost data on the European and country level, the departmental level, the product level;
  • Benchmark RO costs between countries / departments within a country;
  • Perform sensitivity analyses:

                 - costs in case of optimal vs. actual provision
                 - costs in case of evidence-based vs. actual RO practice

  • Estimate budgetary impact of evolutions in technology and RO indications;
  • Evaluate productivity at the national and departmental level.

 Economic evaluation models for RO

The development of economics models to compute the value for money of RO treatments will enable users to:

  • Evaluate and compare the cost-effectiveness and cost-utility of different RO treatments and techniques (new versus standard techniques, RO treatments vs. other oncology treatments);
  • Perform different estimates on gains in outcome, different costs, different countries, different radiotherapy techniques;
  • Compare RO cost-effectiveness with those obtained for other oncology treatments in order to position ourselves within the general oncology landscape.

HERO Group


Cai Grau – Chair – Radiation Oncologist, Aarhus University Hospital (DK)

Yolande Lievens – Chair – Radiation Oncologist, Ghent University Hospital (BE)

Josep Borras – Epidemiologist, Catalan Cancer Strategy, L'Hospitalet de Llobregat. Barcelona (ES)

Mary Coffey – RTT, School of Medicine, Trinity College Dublin (IE)

Peter Dunscombe Ϯ

Lionel Perrier - Health economist, Cancer Centre Léon Bérard, Lyon (FR)

Judith van Loon - Radiation Oncologist, MAASTRO Clinic, Maastricht (NL)

Noémie Defourny – Health Economics Specialist, ESTRO, Brussels (BE)


Marta Bogusz – Radiation Oncologist, Cancer Diagnosis and Treatment Center,Katowice (PL), WP 1

Julian Malicki – Physicist, Great Poland Cancer Centre, Poznan (PL), Work Package 1

Ben Slotman – Radiation Oncologist, VU University Medical Centre, Amsterdam (NL), Work Package 1


The committee is contactable through Chiara Gasparotto at the ESTRO office cgasparotto@estro.org.