Pay per course of radiotherapy, not per session, so short courses are not penalised
Hospitals are paid for each radiotherapy session, so a proven five-session course earns less than an unproven twenty-five-session one. Paying per course removes the reason to give more treatment than needed.
Payers move from per-fraction to episode-based or per-course payment for radiotherapy, with the price set by indication and independent of fraction number, and with a quality bonus for adherence to evidence-based fractionation guidelines. Randomised trials (FAST-Forward, CHHiP, PACE-B, the Dutch and Canadian hypofractionation trials) have shown that shorter courses are equivalent for breast and prostate cancer, yet uptake lags for years in fee-for-service systems. The US Radiation Oncology Model was designed on this principle; implementing it widely, and in other countries, aligns payment with evidence and frees capacity.
- Surgery and radiotherapy cure most, get least · Surgery and radiotherapy cure more people than drugs do, but attract a fraction of the research investment.
- Incentives reward me-too drugs and marginal gains · The system pays the same for a drug that adds two months as for a cure, so companies race to copy rather than to cure.
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not linked directly; found by shared links- IdeaMake one-week radiotherapy the default in overloaded systems
Shares SBRT / SABR (stereotactic radiotherapy), Surgery and radiotherapy cure most, get least, IMRT / IGRT (modern external beam), Prostate cancer.
- IdeaPayer-funded trials that omit surgery or radiotherapy in low-risk patients
Shares Payers fund trials of cheaper, shorter or lower-dose versions of expensive treatments, Surgery and radiotherapy cure most, get least, IMRT / IGRT (modern external beam), Prostate cancer.
- InstitutionAarhus University Hospital
Shares SBRT / SABR (stereotactic radiotherapy), Surgery and radiotherapy cure most, get least, IMRT / IGRT (modern external beam), Prostate cancer.
- IdeaA statutory minimum share of public trial money for surgery and radiotherapy
Shares Core-funded radiotherapy trials infrastructure with central quality assurance, SBRT / SABR (stereotactic radiotherapy), Surgery and radiotherapy cure most, get least, IMRT / IGRT (modern external beam).
- InstitutionHokkaido University Hospital
Shares SBRT / SABR (stereotactic radiotherapy), IMRT / IGRT (modern external beam), Prostate cancer.
- IdeaA public fund and label pathway to trial generic drugs against cancer
Shares Incentives reward me-too drugs and marginal gains, Prostate cancer, HR-positive / HER2-negative breast cancer.
- PersonAnanya Choudhury
Shares Core-funded radiotherapy trials infrastructure with central quality assurance, IMRT / IGRT (modern external beam).
- InstitutionRoyal Adelaide Hospital
Shares IMRT / IGRT (modern external beam), Prostate cancer, HR-positive / HER2-negative breast cancer.