RT Journal Article
SR Electronic
T1 Cost-effectiveness of high-dose MR contrast studies in the evaluation of brain metastases.
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1053
OP 1061
VO 15
IS 6
A1 N A Mayr
A1 W T Yuh
A1 M G Muhonen
A1 D J Fisher
A1 H D Nguyen
A1 J C Ehrhardt
A1 B C Wen
A1 J F Doornbos
A1 D H Hussey
YR 1994
UL http://www.ajnr.org/content/15/6/1053.abstract
AB PURPOSE To investigate the cost-effectiveness of high-dose MR contrast studies in the management of brain metastases. METHODS During the phase III clinical trial of high-dose contrast studies (0.3 mmol/kg), 11 of 27 patients were judged by the reviewers to have potential treatment changes based on the additional information provided by the high-dose studies. We retrospectively evaluated how many of these 27 patients had actual treatment changes because of the results of the high-dose study. Using the fee schedule at our institution, the cost-effectiveness was analyzed based on the cost savings from treatment changes and the additional expense of implementing the high-dose studies. RESULTS A total of 3 craniotomies ($22,800 each) and 2 aggressive courses of radiation therapy ($1122 each) were avoided in 4 patients because of the additional lesions detected by the high-dose studies. This resulted in a treatment cost savings of $70,644. The extra expense for implementing the high-dose study is $9126 for a single injection in all 27 patients, $9295 for 2 separate injections completed in 1 visit in the 11 patients, and $11,154 for 2 separate injections completed in 2 separate visits. The cost savings in management (diagnosis and treatment) therefore ranged from $59,490 to $61,518 for all patients and from $2203 to $2278 per patient. CONCLUSION Based on our limited data, the high-dose study seems to impact positively on the cost-effectiveness in the management of brain metastases. However, because our study had limitations, our results need to be confirmed with a larger patient population and a more standardized treatment approach and fee schedule.