“Scientific evidence can be used to determine the value of proton therapy and allocation of healthcare resources”

Thursday, April 20, 2023

Proton therapy is a relative new way to treat cancer. Although proton therapy has promising results in treatment, it carries high investment and operational costs, which must be seen in a broader perspective and longer time period then regular treatment. A cost-effective analysis model will help to determine to what extent the treatment outcomes justify the costs.

Judy Chen is a PhD researcher at the scientific program HollandPTC Medical Delta program on HTA value proposition. She is researching ways to determine the financial viability of proton therapy at HollandPTC, a proton therapy and research center in Delft that was founded as a result of Medical Delta collaboration between Erasmus MC, LUMC and TU Delft. The model she is developing, can be used to analyse different scenarios and communicate results between different parties, including policy makers and scientists. “With my research, I hope to make a positive impact on society by providing scientific evidence for the allocation of healthcare resources.”

This interview is the seventh in a series of interviews with Medical Delta-funded PhD candidates and postdoctoral researchers. Judy's research is funded by HollandPTC Medical Delta program on HTA value proposition

How did you end up doing this particularly research?

“I began my career as a data analyst in Taiwan, where I spent five years evaluating the risk and benefits of medicines using national data. During my time, I received feedback from clinical and pharmaceutical companies that I neglected the finance aspect in my evaluation. This feedback sparked my curiosity in health economics evaluation, and I decided to study health economy in the Netherlands. Erasmus University has a very strong faculty and research team on all kinds of health economics. After getting my master’s degree, I joined the research team at Erasmus School of Health Policy & Management (ESHPM) at Erasmus University Rotterdam, where I am now developing a model to analyse the financial viability of proton therapy at HollandPTC.

I am passionate about using my research to make an impact on society

As a health economic researcher, I am passionate about using my research to make an impact on society. I aim to provide results that will not only be published in a scientific journal, but can actually be used by the government for their evidence based decision-making.

ESHPM - with its strong research team, industry connections and government ties - provides an ideal platform for me to achieve this goal. Based on my previous working experience, I know how important it is to take real world data into account for this kind of research. Working at ESHPM has given me the opportunity to combine my research and analytical skills in health economics research and collaborate with experts from various fields.”

Photo: Guido Benschop

What do you hope to achieve with your research?

“My aim is to determine the value of proton therapy by assessing both its treatment value and the costs. Therefore, we are conducting a cost-effective analysis. We create a model to combine data, simulate real-world situations and allow for different scenarios to be analysed by changing input parameters. For instance: what if the price of proton therapy will go down by a certain amount in the next ten years? By simulating the benefits and costs of proton therapy from a societal perspective, I aim to determine if it brings welfare to society as a whole and, if so, to what extent.

To build this model, real-world data such as patient and disease characteristics and resource use from patients treated at HollandPTC are being collected. Once the model is made, it can be used for future adjustments and simulations, and the parameters can be changed to inform future decisions. The model is also a graphical representation, which makes it easy to communicate results between different parties, including policy makers and scientists. It will help finding common ground for discussion.

I aspire that our model and research will serve as a framework that can be used for well informed decision making worldwide

The research is not limited to HollandPTC: we are exploring national and international collaborations. In the Netherlands, there is the ProTrait initiative and HollandPTC is part of the European PROTECT-trial research consortium. Numerous proton therapy centers are present but operate in different healthcare systems. We aim to develop a flexible model that can be adjusted to different healthcare settings. Therefore, I aspire that our model and research will serve as a framework that can be used for well informed decision making worldwide.”

What new insights have you gained from collaborating with different scientific fields?

"The collaboration between Erasmus University Rotterdam and HollandPTC within my research is strong. I rely on HollandPTC to collect data from their patients and the radiation oncologists to get the necessary clinical insights for me to analyse and interpret the data correctly. There is a close relationship with physicians, nurses and radiation therapists, which helps to map the treatment processes of the center as a whole. I also rely on HollandPTC to get questionnaires to the patients, and the collaboration has proven to be a learning experience for us both.

I regularly communicated with Medical Delta professor Marco van Vulpen, the former medical director of HollandPTC and professor in radiotherapy at Leiden UMC, Erasmus MC and TU Delft, to discuss the research direction and where the focus should be. As a pharmacist and health economics researcher, I didn’t know much about radiotherapy and proton therapy, so the research in this field is a whole new experience for me. I really learned a lot thanks to the close collaboration.”

Photo: Guido Benschop

What advice would you give Medical Delta researchers who just get started?

“My advice would be that you shouldn’t be afraid of doing research in a field you are not familiar with. You can always contribute based on your skill set and the knowledge you already have, and learn new things at the same time. As long as you are open minded and willing to learn, you will achieve nice results in the end.

Communication is important for research in different fields. Of course there are differences, in using different phrases for instance. And clinicians have the clinical side as their main focus. But that is not a problem in collaborated research, as long as you have common goals and are able to show why it is important for everyone.”

The previous interviewee, Chantal Eenkhoorn, wants to know: what are you most proud of?

“I take pride in the flexibility of the model that I am developing, which can be used to analyse various scenarios. Its ability to inform policy makers and make a positive impact on society is something that I am particularly proud of. By using my model, governments can make informed decisions about whether or not to allocate healthcare resources for proton therapy based on scientific evidence. In the end, this will benefit society as a whole.”

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