{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:57:44Z","timestamp":1786121864784,"version":"build-2736575974"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012681","name":"Universit\u00e4tsklinikum K\u00f6ln","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012681","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Health Econ"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Non-randomized clinical trial has shown that Magnetic Resonance guided High-intensity focused ultrasound (MR-HIFU) leads to faster pain relief compared to the current standard of care External Beam Radiotherapy (EBRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the cost-utility of \u2019early MR-HIFU\u2019 (with optional EBRT afterwards) or \u2018delayed MR-HIFU\u2019 (i.e., MR-HIFU after failed EBRT) versus EBRT (with optional re-irradiation with EBRT) from the societal perspective in the Netherlands<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A lifelong patient-level simulation model was developed. After a treatment with either MR-HIFU or EBRT, a patient could have: (i) complete pain relief, (ii) partial pain relief, (iii) persistent pain and (iv) death. We also accounted for the event of a pathological fracture. Model outputs were costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICER). The net monetary benefit was calculated considering the willingness-to-pay threshold of \u20ac80,000 per QALY gained, adjusted by the Dutch disease severity index. Deterministic and probabilistic sensitivity analyses were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The strategy \u2018delayed MR-HIFU\u2019 costs \u20ac706 more than EBRT, whilst \u2018early MR-HIFU\u2019 costs \u20ac1,875 more than EBRT.\u2018Early MR-HIFU\u2019 adds 0,15 more QALYs than EBRT, resulting in an ICER of \u20ac12.755 per QALY and an incremental net monetary benefit of \u20ac8,631. At a threshold of 80,000\u20ac per QALY there is a 77% probability that \u2018early MR-HIFU\u2019 is the most cost-effective option.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although there are still uncertainties relating to implementation of MR-HIFU in patient care, our modelling study shows that offering MR-HIFU as an early treatment would be the most cost-effective option in the Netherlands.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10198-025-01861-9","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T05:54:10Z","timestamp":1764914050000},"page":"1061-1072","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-utility of focused ultrasound compared to radiotherapy for Dutch patients with uncomplicated non-spinal bone metastases"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4832-7294","authenticated-orcid":false,"given":"Julia","family":"Sim\u00f5es Corr\u00eaa Galendi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4820-7505","authenticated-orcid":false,"given":"Ingrid","family":"Nijholt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0858-7472","authenticated-orcid":false,"given":"Ren\u00e9e","family":"Hovenier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3358-1986","authenticated-orcid":false,"given":"Jorik","family":"Slotman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9142-1460","authenticated-orcid":false,"given":"Erik","family":"Phernambucq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1726-9300","authenticated-orcid":false,"given":"Stephanie","family":"Stock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9246-3242","authenticated-orcid":false,"given":"Clemens","family":"Bos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6580-4331","authenticated-orcid":false,"given":"Manon","family":"Braat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9480-1623","authenticated-orcid":false,"given":"Helena","family":"Verkooijen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7878-0970","authenticated-orcid":false,"given":"Martijn","family":"Boomsma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5576-0192","authenticated-orcid":false,"given":"Dirk","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"1861_CR1","doi-asserted-by":"publisher","first-page":"115272","DOI":"10.1016\/j.bone.2020.115272","volume":"134","author":"D Oostinga","year":"2020","unstructured":"Oostinga, D., Steverink, J.G., van Wijck, A.J.M., Verlaan, J.J.: An understanding of bone pain: A narrative review. Bone 134, 115272 (2020). https:\/\/doi.org\/10.1016\/j.bone.2020.115272","journal-title":"Bone"},{"issue":"3","key":"1861_CR2","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.radonc.2018.01.003","volume":"126","author":"SE Rich","year":"2018","unstructured":"Rich, S.E., et al.: Update of the systematic review of palliative radiation therapy fractionation for bone metastases. Radiother Oncol 126(3), 547\u2013557 (2018). https:\/\/doi.org\/10.1016\/j.radonc.2018.01.003","journal-title":"Radiother Oncol"},{"key":"1861_CR3","doi-asserted-by":"publisher","first-page":"Cd004721","DOI":"10.1002\/14651858.Cd004721","volume":"2002","author":"WM Sze","year":"2004","unstructured":"Sze, W.M., Shelley, M., Held, I., Mason, M.: Palliation of metastatic bone pain: single fraction versus multifraction radiotherapy - a systematic review of the randomised trials. Cochrane Database Syst Rev 2002, Cd004721 (2004). https:\/\/doi.org\/10.1002\/14651858.Cd004721","journal-title":"Cochrane Database Syst Rev"},{"key":"1861_CR4","doi-asserted-by":"publisher","unstructured":"Yeo, S.Y., Bratke, G., Gr\u00fcll, H.: High Intensity Focused Ultrasound for Treatment of Bone Malignancies-20 Years of History, (in eng), Cancers (Basel),15(1) Dec 24 (2022). https:\/\/doi.org\/10.3390\/cancers15010108","DOI":"10.3390\/cancers15010108"},{"key":"1861_CR5","doi-asserted-by":"publisher","unstructured":"Hurwitz, M.D., et al.: Magnetic resonance-guided focused ultrasound for patients with painful bone metastases: phase III trial results, (in eng), J Natl Cancer Inst, 106(5) Apr 23 (2014). https:\/\/doi.org\/10.1093\/jnci\/dju082","DOI":"10.1093\/jnci\/dju082"},{"issue":"2","key":"1861_CR6","doi-asserted-by":"publisher","first-page":"e211857","DOI":"10.1148\/radiol.211857","volume":"307","author":"A Napoli","year":"2023","unstructured":"Napoli, A., et al.: Focused Ultrasound and External Beam Radiation Therapy for Painful Bone Metastases: A Phase II Clinical Trial. Radiology 307(2), e211857 (2023). https:\/\/doi.org\/10.1148\/radiol.211857","journal-title":"Radiology"},{"issue":"3","key":"1861_CR7","doi-asserted-by":"publisher","first-page":"251","DOI":"10.3109\/02656736.2014.995237","volume":"31","author":"M Huisman","year":"2015","unstructured":"Huisman, M., et al.: International consensus on use of focused ultrasound for painful bone metastases: Current status and future directions, (in eng). Int. J. Hyperth. 31(3), 251\u2013259 . https:\/\/doi.org\/10.3109\/02656736.2014.995237","journal-title":"Int. J. Hyperth."},{"key":"1861_CR8","doi-asserted-by":"publisher","unstructured":"Sim\u00f5es Corr\u00eaa, J., Galendi, et al.: Factors influencing the adoption of magnetic Resonance-Guided High-Intensity focused ultrasound for painful bone metastases in Europe, A group concept mapping Study, (in eng). Int. J. Environ. Res. Public. Health. 20(2) (Jan 7 2023). https:\/\/doi.org\/10.3390\/ijerph20021084","DOI":"10.3390\/ijerph20021084"},{"issue":"10","key":"1861_CR9","doi-asserted-by":"publisher","first-page":"575","DOI":"10.15171\/ijhpm.2019.36","volume":"8","author":"JPC Grutters","year":"2019","unstructured":"Grutters, J.P.C., Govers, T., Nijboer, J., Tummers, M., van der Wilt, G.J., Rovers, M.M.: Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling. International journal of health policy and management 8(10), 575\u2013582 (2019). https:\/\/doi.org\/10.15171\/ijhpm.2019.36","journal-title":"International journal of health policy and management"},{"issue":"2","key":"1861_CR10","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.clinthera.2022.01.011","volume":"44","author":"D Husereau","year":"2022","unstructured":"Husereau, D., Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS: Statement: Updated Reporting Guidance for Health Economic Evaluations. Clin Ther 44(2), 158\u2013168 (2022). https:\/\/doi.org\/10.1016\/j.clinthera.2022.01.011","journal-title":"Clin Ther"},{"key":"1861_CR11","unstructured":"Zorginstituut Nederland: Guideline for economic evaluations in healthcare. (2024). https:\/\/english.zorginstituutnederland.nl\/publications\/reports\/2016\/06\/16\/guideline-for-economic-evaluations-in-healthcare (accessed 12"},{"key":"1861_CR12","doi-asserted-by":"publisher","unstructured":"Hovenier, R., Bos, C., Boomsma, M.F., Gr\u00fcll, H., Morganti, A.G., Verkooijen, H.M.: Interrater agreement in assessment of eligibility for magnetic Resonance-Guided high intensity focused ultrasound (MR-HIFU) of patients with painful bone Metastases, (in eng). J Vasc Interv Radiol. Jan. 21 (2025). https:\/\/doi.org\/10.1016\/j.jvir.2025.01.025","DOI":"10.1016\/j.jvir.2025.01.025"},{"key":"1861_CR13","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.radonc.2022.05.024","volume":"173","author":"J van der Velden","year":"2022","unstructured":"van der Velden, J., et al.: ESTRO ACROP guidelines for external beam radiotherapy of patients with uncomplicated bone metastases. Radiother. Oncol. 173, 197\u2013206 (2022). https:\/\/doi.org\/10.1016\/j.radonc.2022.05.024","journal-title":"Radiother. Oncol."},{"issue":"no. 1","key":"1861_CR14","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-022-06942-1","volume":"23","author":"DJ Slotman","year":"2022","unstructured":"Slotman, D.J., et al.: Focused Ultrasound and RadioTHERapy for non-invasive palliative pain treatment in patients with bone metastasis: a study protocol for the three armed randomized controlled FURTHER trial. Trials 23(1), 1061 (2022). https:\/\/doi.org\/10.1186\/s13063-022-06942-1","journal-title":"Trials"},{"issue":"3","key":"1861_CR15","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1093\/jnci\/95.3.222","volume":"95","author":"WB van den Hout","year":"2003","unstructured":"van den Hout, W.B., et al.: Single- versus multiple-fraction radiotherapy in patients with painful bone metastases: cost-utility analysis based on a randomized trial, (in eng). J. Natl. Cancer Inst. 95(3), 222\u2013229 (2003). https:\/\/doi.org\/10.1093\/jnci\/95.3.222","journal-title":"J. Natl. Cancer Inst."},{"key":"1861_CR16","doi-asserted-by":"publisher","first-page":"987546","DOI":"10.3389\/fonc.2022.987546","volume":"12","author":"J Sim\u00f5es Corr\u00eaa","year":"2022","unstructured":"Sim\u00f5es Corr\u00eaa, J., Galendi, et al.: Early economic modeling of magnetic resonance image-guided high intensity focused ultrasound compared to radiotherapy for pain palliation of bone metastases, (in eng). Front. Oncol. 12, 987546 (2022). https:\/\/doi.org\/10.3389\/fonc.2022.987546","journal-title":"Front. Oncol."},{"issue":"2","key":"1861_CR17","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1007\/s40273-013-0121-y","volume":"32","author":"J Jayasekera","year":"2014","unstructured":"Jayasekera, J., Onukwugha, E., Bikov, K., Mullins, C.D., Seal, B., Hussain, A.: The economic burden of skeletal-related events among elderly men with metastatic prostate cancer, (in eng). Pharmacoeconomics 32(2), 173\u201391 (2014). https:\/\/doi.org\/10.1007\/s40273-013-0121-y","journal-title":"Pharmacoeconomics"},{"issue":"2","key":"1861_CR18","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/S0167-8140(99)00097-3","volume":"52","author":"JR Yarnold","year":"1999","unstructured":"Yarnold, J.R.: 8 Gy single fraction radiotherapy for the treatment of metastatic skeletal pain: randomised comparison with a multifraction schedule over 12 months of patient follow-up. Bone Pain Trial Working Party, (in eng). Radiother Oncol 52(2), 111\u201321 (1999). https:\/\/doi.org\/10.1016\/S0167-8140(99)00097-3","journal-title":"Radiother Oncol"},{"issue":"1","key":"1861_CR19","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s10198-012-0443-2","volume":"15","author":"LS Matza","year":"2014","unstructured":"Matza, L.S., et al.: Health state utilities for skeletal-related events secondary to bone metastases, (in eng). Eur. J. Health Econ. 15(1), 7\u201318 . https:\/\/doi.org\/10.1007\/s10198-012-0443-2","journal-title":"Eur. J. Health Econ."},{"key":"1861_CR20","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/1477-7525-9-9610.1186\/1477-7525-9-96","volume":"9","author":"S Dixon","year":"2011","unstructured":"Dixon, S., Poole, C.D., Odeyemi, I., Retsa, P., Chambers, C., Currie, C.J.: Deriving health state utilities for the numerical pain rating scale, (in eng). Health Qual Life Outcomes 9, 96 (2011). https:\/\/doi.org\/10.1186\/1477-7525-9-9610.1186\/1477-7525-9-96","journal-title":"Health Qual Life Outcomes"},{"key":"1861_CR21","doi-asserted-by":"publisher","first-page":"e30","DOI":"10.1017\/s0266462320001907","volume":"37","author":"MD Bucknor","year":"2020","unstructured":"Bucknor, M.D., Chan, F.P., Matuoka, J.Y., Curl, P.K., Kahn, J.G.: Cost-effectiveness analysis of magnetic resonance-guided focused ultrasound ablation for palliation of refractory painful bone metastases, (in eng). Int J Technol Assess Health Care 37, e30 (2020). https:\/\/doi.org\/10.1017\/s0266462320001907","journal-title":"Int J Technol Assess Health Care"},{"issue":"1","key":"1861_CR22","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1080\/02656736.2021.2023768","volume":"39","author":"J Sim\u00f5es Corr\u00eaa","year":"2022","unstructured":"Sim\u00f5es Corr\u00eaa, J., Galendi, S.Y., Yeo, D., Simic, H., Gr\u00fcll, S., Stock, M\u00fcller, D.: A time-driven activity-based costing approach of magnetic resonance-guided high-intensity focused ultrasound for cancer-induced bone pain, (in eng). Int. J. Hyperth. 39(1), 173\u2013180 (2022). https:\/\/doi.org\/10.1080\/02656736.2021.2023768","journal-title":"Int. J. Hyperth."},{"key":"1861_CR23","unstructured":"De Nederlandse Federatie van Universitair Medische Centra: Cao University Medical Centres 2024\u20132025. (2024). https:\/\/www.nfu.nl\/sites\/default\/files\/2024-09\/Cao_2024-2025_NFU-24.01132_ENG.pdf"},{"key":"1861_CR24","unstructured":"Zorginstituut Nederland: Costing manual: Methods and Reference Prices for Economic Evaluations in Healthcare"},{"issue":"3","key":"1861_CR25","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.clinthera.2011.04.002","volume":"33","author":"AD Joshi","year":"2011","unstructured":"Joshi, A.D., Carter, J.A., Botteman, M.F., Kaura, S.: Cost-effectiveness of zoledronic acid in the management of skeletal metastases in patients with lung cancer in France, Germany, Portugal, the Netherlands, and the United kingdom, (in eng). Clin. Ther. 33(3), 291-304e8 (2011). https:\/\/doi.org\/10.1016\/j.clinthera.2011.04.002","journal-title":"Clin. Ther."},{"key":"1861_CR26","unstructured":"Central Bureau of Statistics: Consumer prices index https:\/\/www.cbs.nl\/nl-nl\/ (2023). accessed 18 May"},{"issue":"4","key":"1861_CR27","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1007\/s13566-018-0363-6","volume":"7","author":"JM van der Velden","year":"2018","unstructured":"van der Velden, J.M., et al.: Evaluation of effectiveness of palliative radiotherapy for bone metastases: A prospective cohort study, (in eng). J. Radiat. Oncol. 7(4), 325\u2013333 (2018). https:\/\/doi.org\/10.1007\/s13566-018-0363-6","journal-title":"J. Radiat. Oncol."},{"issue":"8","key":"1861_CR28","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1016\/j.jvir.2020.03.027","volume":"31","author":"EM Chang","year":"2020","unstructured":"Chang, E.M., Shaverdian, N., Capiro, N., Steinberg, M.L., Raldow, A.C.: Cost Effectiveness of External Beam Radiation Therapy versus Percutaneous Image-Guided Cryoablation for Palliation of Uncomplicated Bone Metastases, (in eng). J. Vasc Interv Radiol. 31(8), 1221\u20131232 (2020). https:\/\/doi.org\/10.1016\/j.jvir.2020.03.027","journal-title":"J. Vasc Interv Radiol."},{"issue":"2","key":"1861_CR29","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/s1470-2045(13)70556-4","volume":"15","author":"E Chow","year":"2014","unstructured":"Chow, E., et al.: Single versus multiple fractions of repeat radiation for painful bone metastases: a randomised, controlled, non-inferiority trial. Lancet Oncol 15(2), 164\u201371 (2014). https:\/\/doi.org\/10.1016\/s1470-2045(13)70556-4","journal-title":"Lancet Oncol"},{"key":"1861_CR30","unstructured":"Nederland, Z.: Medicijnkosten https:\/\/www.medicijnkosten.nl (2023). accessed 18 May"},{"issue":"4","key":"1861_CR31","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.clon.2017.12.023","volume":"30","author":"D Harding","year":"2018","unstructured":"Harding, D., et al.: Evaluation of Quality of Life Outcomes Following Palliative Treatment of Bone Metastases with Magnetic Resonance-guided High Intensity Focused Ultrasound: An International Multicentre Study, (in eng). Clin. Oncol. (R Coll. Radiol) 30(4), 233\u2013242 (2018). https:\/\/doi.org\/10.1016\/j.clon.2017.12.023","journal-title":"Clin. Oncol. (R Coll. Radiol)"},{"issue":"no. 3","key":"1861_CR32","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1002\/ejp.1139","volume":"22","author":"TR Mendoza","year":"2018","unstructured":"Mendoza, T.R., et al.: The contribution of pain in determining the health status of cancer patients with bone metastases: A secondary analysis of data from three Phase III registration trials. Eur J Pain 22(3), 565\u2013571 (2018). https:\/\/doi.org\/10.1002\/ejp.1139","journal-title":"Eur J Pain"},{"issue":"3","key":"1861_CR33","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1016\/j.ijrobp.2015.06.024","volume":"93","author":"PG Westhoff","year":"2015","unstructured":"Westhoff, P.G., et al.: Quality of Life in Relation to Pain Response to Radiation Therapy for Painful Bone Metastases, (in eng). Int. J. Radiat. Oncol. Biol. Phys. 93(3), 694\u2013701 (2015). https:\/\/doi.org\/10.1016\/j.ijrobp.2015.06.024. (Nov 1 2015)","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"issue":"4","key":"1861_CR34","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s40273-015-0327-2","volume":"34","author":"P Vemer","year":"2016","unstructured":"Vemer, P., Corro Ramos, I., van Voorn, G.A., Al, M.J., Feenstra, T.L.: Validation-Assessment Tool of Health-Economic Models for Decision Makers and Model Users, (in eng),. Pharmacoeconomics 34(4), 349\u201361 (2016). https:\/\/doi.org\/10.1007\/s40273-015-0327-2","journal-title":"Pharmacoeconomics"},{"key":"1861_CR35","unstructured":"York Health Economics Consortium: Net Monetary Benefit [online]. (2023). https:\/\/yhec.co.uk\/glossary\/net-monetary-benefit\/ (accessed 24"},{"key":"1861_CR36","doi-asserted-by":"crossref","unstructured":"Briggs, A., Sculpher, M., Claxton, K.: Decision modelling for health economic evaluation. Oup Oxford, (2006)","DOI":"10.1093\/oso\/9780198526629.001.0001"},{"key":"1861_CR37","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.ejca.2017.03.031","volume":"79","author":"J Schr\u00f6der","year":"2017","unstructured":"Schr\u00f6der, J., et al.: Treatment and pattern of bone metastases in 1094 patients with advanced breast cancer - Results from the prospective German Tumour Registry Breast Cancer cohort study, (in eng). Eur J Cancer 79, 139\u2013148 (2017). https:\/\/doi.org\/10.1016\/j.ejca.2017.03.031","journal-title":"Eur J Cancer"},{"issue":"9","key":"1861_CR38","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016022","volume":"7","author":"E Svensson","year":"2017","unstructured":"Svensson, E., Christiansen, C.F., Ulrichsen, S.P., R\u00f8rth, M.R., S\u00f8rensen, H.T.: Survival after bone metastasis by primary cancer type: a Danish population-based cohort study. BMJ open 7(9), e016022 (2017). https:\/\/doi.org\/10.1136\/bmjopen-2017-016022","journal-title":"BMJ open"},{"issue":"1","key":"1861_CR39","doi-asserted-by":"publisher","DOI":"10.1038\/s43856-023-00304-x","volume":"3","author":"NL Hudock","year":"2023","unstructured":"Hudock, N.L., et al.: Future trends in incidence and long-term survival of metastatic cancer in the United States. Communications Medicine 3(1), 76 (2023). https:\/\/doi.org\/10.1038\/s43856-023-00304-x","journal-title":"Communications Medicine"},{"key":"1861_CR40","doi-asserted-by":"crossref","unstructured":"Hovenier, R., et al.: Eligibility for Magnetic Resonance-Guided High Intensity Focused Ultrasound in Patients Referred for Radiotherapy on Painful Nonspinal Bone Metastases, International Journal of Clinical Practice, (1)4962457 (2025)","DOI":"10.1155\/ijcp\/4962457"},{"issue":"6","key":"1861_CR41","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1016\/j.jval.2020.02.004","volume":"23","author":"A Etges","year":"2020","unstructured":"Etges, A., Ruschel, K.B., Polanczyk, C.A., Urman, R.D.: Advances in Value-Based Healthcare by the Application of Time-Driven Activity-Based Costing for Inpatient Management: A Systematic Review. Value Health 23(6), 812\u2013823 (2020). https:\/\/doi.org\/10.1016\/j.jval.2020.02.004","journal-title":"Value Health"},{"issue":"1","key":"1861_CR42","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.ijrobp.2011.10.080","volume":"84","author":"M Huisman","year":"2012","unstructured":"Huisman, M., van den Bosch, M.A.A.J., Wijlemans, J.W., van Vulpen, M., van der Linden, Y.M., Verkooijen, H.M.: Effectiveness of reirradiation for painful bone metastases: A systematic review and Meta-Analysis. Int. J. Radiat. Oncol. Biol. Phys. 84(1), 8\u201314 (2012). https:\/\/doi.org\/10.1016\/j.ijrobp.2011.10.080","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"issue":"3","key":"1861_CR43","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1016\/j.ijrobp.2019.07.009","volume":"105","author":"K Spencer","year":"2019","unstructured":"Spencer, K., Velikova, G., Henry, A., Westhoff, P., Hall, P.T., van der Linden, Y.M.: Net Pain Relief After Palliative Radiation Therapy for Painful Bone Metastases: A Useful Measure to Reflect Response Duration? A Further Analysis of the Dutch Bone Metastasis Study, (in eng). Int. J. Radiat. Oncol. Biol. Phys. 105(3), 559\u2013566 (2019). https:\/\/doi.org\/10.1016\/j.ijrobp.2019.07.009","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"issue":"6","key":"1861_CR44","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1002\/jor.24660","volume":"38","author":"TA Damron","year":"2020","unstructured":"Damron, T.A., Mann, K.A.: Fracture risk assessment and clinical decision making for patients with metastatic bone disease, (in eng). J. Orthop. Res. 38(6), 1175\u20131190 (2020). https:\/\/doi.org\/10.1002\/jor.24660","journal-title":"J. Orthop. Res."},{"key":"1861_CR45","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1474376","volume":"12","author":"J Corral","year":"2024","unstructured":"Corral, J., et al.: Challenges in assessing National radiotherapy costs: Application of the ESTRO-HERO model in Spain. Front. Public. Health. 12, 1474376 (2024). https:\/\/doi.org\/10.3389\/fpubh.2024.1474376","journal-title":"Front. Public. Health."},{"key":"1861_CR46","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.radonc.2019.06.015","volume":"138","author":"N Defourny","year":"2019","unstructured":"Defourny, N., et al.: National costs and resource requirements of external beam radiotherapy: A time-driven activity-based costing model from the ESTRO-HERO project. Radiother Oncol 138, 187\u2013194 (2019). https:\/\/doi.org\/10.1016\/j.radonc.2019.06.015","journal-title":"Radiother Oncol"}],"container-title":["The European Journal of Health Economics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10198-025-01861-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10198-025-01861-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10198-025-01861-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T06:54:51Z","timestamp":1786085691000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10198-025-01861-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,5]]},"references-count":46,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["1861"],"URL":"https:\/\/doi.org\/10.1007\/s10198-025-01861-9","relation":{},"ISSN":["1618-7598","1618-7601"],"issn-type":[{"value":"1618-7598","type":"print"},{"value":"1618-7601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,5]]},"assertion":[{"value":"5 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"No ethical approval has been asked to perform the current study due to the non-involvement of human participants.","order":1,"name":"Ethics","label":"Ethical statement","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}