Early health economic analysis of 1.5 T MRI-guided radiotherapy for localized prostate cancer: Decision analytic modelling

Highlights: • The ongoing technical development challenges to define a clear value proposition. • Results offer insight into key elements for investment choices and future studies. • MR-Linac is found to be cost-effective compared to EBRT 20 and 39 fractions. • Comparisons with EBRT 5 fractions and LDR brachytherapy are most challenging. 1.5 Tesla magnetic resonance imaging radiotherapy linear accelerator (MR-Linac) is gaining interest for treatment of localized prostate cancer. Clinical evidence is lacking and it therefore remains uncertain whether MR-Linac is cost-effective. An early health economic analysis was performed to calculate the necessary relative reduction in complications and the maximum price of MR-Linac (5 fractions) to be cost-effective compared to 5, 20 and 39 fractionation schedules of external beam radiotherapy (EBRT) and low-dose-rate (LDR) brachytherapy.