Championing NHS Adoption of MRI-guided radiotherapy: Health Innovation KSS supports Elekta Unity

Summary

Elekta Unity combines magnetic resonance imaging (MRI) with a medical linear accelerator (linac) to improve precision radiotherapy for cancer, potentially reducing treatment burden for patients while improving outcomes. Health Innovation KSS commissioned Unity Insights to undertake a cost-benefit analysis and created a budget impact model. The analysis found the Elekta Unity MR-Linac can be economically viable with sufficient patient volume, offering better quality of life for patients and aligning with NHS Long Term Plan priorities.

Challenge

Radiotherapy uses radiation to destroy cancer cells by damaging DNA, aiming to give a high radiation dose to cancer cells while minimising exposure to healthy tissue. There is still an unmet medical need for new radiotherapy systems that offer enhanced precision and accuracy.

Soft tissue cancers are those that undergo position or shape changes during radiotherapy or between scanning and treatment sessions. They can be harder to treat and are affected by breathing, bladder filling, or bowel changes.

Elekta Unity integrates an MRI scanner and a linac to offer continuous anatomy-specific imaging and motion management. Here, the aim is to improve the precision and efficacy of radiotherapy treatment, reducing the number of treatments required by the patient through hypofractionation. Hypofractionation in radiation therapy refers to a treatment approach where the total dose of radiation is divided into fewer, larger doses (fractions) and delivered over a shorter period of time compared to traditional radiation therapy. The innovation is particularly beneficial for the treatment of soft tissue cancers.

Elekta Unity aligns with the NHS Long Term Plan priorities for cancer care including improving treatment, diagnosis, and personalising care, and improving the outcomes and experience of patients receiving NHS radiotherapy in England.

Approach

Health Innovation Kent Surrey Sussex (KSS) have been supporting Elekta as their local health innovation network as part of our Office for Life Sciences commission. Elekta registered the Unity MR-Linac with the NHS Innovation Service to receive this support.

Health Innovation KSS supported Elekta with a needs assessment as well as commissioning Unity Insights to conduct a cost-benefit analysis (CBA), and to develop a budget-impact model (BIM).

A literature review was undertaken to provide the basis of the health economic analysis, focusing the health economic modelling on two types of cancer: prostate and unresectable pancreatic cancer. Relevant data and insights were drawn from comparable studies, sourced from case studies, clinical trials, evaluations, and other research. The approach used, and key assumptions included in the models, were presented to a group of clinicians and Allied Health Professionals (AHPs), recruited by Elekta Unity from various NHS Foundation Trusts such as The Royal Marsden, The Christie, The Clatterbridge Cancer Centre, and The James Cook University Hospital. This session gathered feedback and critique from clinical experts in the field. The CBA provided further evidence of the potential economic impact of Elekta Unity, where the BIM was provided as a tool to inform the financial impact of adopting Elekta Unity. The outputs will support and help inform the next steps for Elekta Unity.

Elekta Unity is simultaneously part of the international MOMENTUM Study, the largest prospective international registry of high field MR-guided radiotherapy, currently enrolling patients from 15 major cancer centres in North America, Europe and Australia. In England, the Elekta Unity MR-Linac is used in two NHS Trusts (The Royal Marsden and The Christie hospitals). The MOMENTUM study is focused on collecting clinical and technical patient data and patient reported outcomes. This case study does not focus on the findings from this study.

“We have been delighted with the support received from Health Innovation KSS. They introduced a different way of approaching the introduction of new technologies, bringing on board expertise from across their network, including the health economists Unity Insights. Their novel approach, combined with their guidance and expertise, is propelling us forward within the NHS landscape.” – Ben Huard, Business Manager MR Linac, Elekta Limited.

 

Findings

Economic Impact

The CBA identified that the use of Elekta Unity allowed hypofractionation, which lowered the cost per course of radiotherapy treatment from fewer fractions and increased in patient quality of life indicators (QALYs) for unresectable pancreatic cancer patients.

This reduction in the total treatment cost per patient resulted in an improved return on investment. Increasing patient throughput would allow more people to benefit and improve the value of the system further, which will in turn help recoup the relatively high upfront costs of implementation.

Wider impact (health and care system / patients)

Elekta Unity MR-Linac has the potential to significantly improve outcomes for patients, particularly those with unresectable pancreatic cancer.

Previous studies have shown that treatments with MR-Linac technology offer potential reductions in overall treatment times, side effects, and other inconveniences such as a reduction in travel to appointments.

For healthcare professionals, the ability to visualise tumours during radiation delivery enhances precision, enabling higher doses for more effective treatment, while avoiding adjacent healthy organs.

Next steps and scalability

The CBA and the BIM have added to the evidence base Elekta Unity are currently building to establish procurement routes to the NHS. This work has been a crucial step on Elekta’s journey with the Unity MR-Linac. It has allowed them to understand the next steps and guide the decision-making around the real-world evidence they now need to gather. Health Innovation KSS is continuing to support them on the next steps of this process.

Find out more

Find out more about Elekta Unity here