The socio-economic impact of the National Hadrontherapy Centre for Cancer Treatment (CNAO): applying a CBA analytical framework

This paper provides an assessment of the net welfare impact of the National Hadrontherapy Centre for Cancer Treatment (CNAO) located in Pavia (Italy) in a thirty year-time period. CNAO is an applied research facility specialised in hadrontherapy, an advanced oncological treatment showing clinical advantages as compared to traditional radiotherapy, at the same time being more expensive as it exploits accelerators technology and sophisticated control and dose delivery systems. The methodology used to assess costs and benefits draws from the standard cost-benefit analysis (CBA) adapted in an innovative framework developed to account for the specificities of research infrastructures and complemented by risk analysis. The analysis shows that with a fairly high probability the centre provides a net contribution to society’s welfare. Source of benefits are mainly health treatments to patients, for whom gains in terms of longer or better lives are guaranteed as compared to a counterfactual situation where they are treated with conventional therapies. Such benefits are the direct consequences of the application to end users of the knowledge developed in the centre with research activities and are quantified and assessed on the basis of conventional economic evaluation approaches for health benefits. Additional benefits generated by the centre are typical of research infrastructures in different scientific domains and refer to technological spillovers (namely creation of spin-offs, technological transfer to companies in the supply chain and to other similar facilities), knowledge creation (production of scientific outputs), human capital formation (training of doctoral students, technicians and professionals in the field of hadrontherapy) and cultural outreach (students, researchers and wider public visiting the facilities). This test shows that a CBA framework for assessing the impact of a particle accelerator specifically designed to provide medical treatment is a promising avenue as compared to existing alternative methodologies informing decision-making. Further research is however needed to fine tune the methodology, in particular for what concerns technological spillovers and knowledge creation benefits.