Linear accelerator maintenance cost analysis.

Purpose: Medical linear accelerators are the most costly standard equipment used in radiation oncology, however the service costs for these machines are not well understood. With an increasing demand for linear accelerators due to a global increase in cancer incidence, it is important to understand the expected maintenance costs of a larger global installed base so that these costs can be incorporated into budgeting. The purpose of this investigation is to analyze the costs for medical linear accelerator service and maintenance at our institution, in order to estimate the service cost ratio.

Methods: We collected the costs of parts used for all service work done on 32 medical linear accelerators over a two year period. The data was segregated by center, machine, linear accelerator type, and failure area in the machine.

Results: We found the service cost ratio (excluding software support expenses) to be 3.13% [2.74%, 3.52%,]. We observed a variability of parts costs, and overall variability of the service cost ratio to be between 2.14% and 5.25%. This result is lower than other estimates for service costs for medical equipment in general and medical linear accelerators specifically. Two-thirds of the service costs were due to labor costs, which indicate the importance of a well-trained service technician workforce.

Conclusions: We estimated the service cost ratio for medical linear accelerators to be 3.13% [3.52%, 2.74%] of the initial capital cost. This result was lower than other estimates of the service cost ratio.