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Abstract

Cost-effectiveness of high-dose MR contrast studies in the evaluation of brain metastases.

N A Mayr, W T Yuh, M G Muhonen, D J Fisher, H D Nguyen, J C Ehrhardt, B C Wen, J F Doornbos and D H Hussey
American Journal of Neuroradiology June 1994, 15 (6) 1053-1061;
N A Mayr
Department of Radiology, University of Iowa College of Medicine, Iowa City.
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W T Yuh
Department of Radiology, University of Iowa College of Medicine, Iowa City.
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M G Muhonen
Department of Radiology, University of Iowa College of Medicine, Iowa City.
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D J Fisher
Department of Radiology, University of Iowa College of Medicine, Iowa City.
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H D Nguyen
Department of Radiology, University of Iowa College of Medicine, Iowa City.
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J C Ehrhardt
Department of Radiology, University of Iowa College of Medicine, Iowa City.
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B C Wen
Department of Radiology, University of Iowa College of Medicine, Iowa City.
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J F Doornbos
Department of Radiology, University of Iowa College of Medicine, Iowa City.
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D H Hussey
Department of Radiology, University of Iowa College of Medicine, Iowa City.
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Abstract

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.

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American Journal of Neuroradiology
Vol. 15, Issue 6
1 Jun 1994
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Cost-effectiveness of high-dose MR contrast studies in the evaluation of brain metastases.
N A Mayr, W T Yuh, M G Muhonen, D J Fisher, H D Nguyen, J C Ehrhardt, B C Wen, J F Doornbos, D H Hussey
American Journal of Neuroradiology Jun 1994, 15 (6) 1053-1061;

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Cost-effectiveness of high-dose MR contrast studies in the evaluation of brain metastases.
N A Mayr, W T Yuh, M G Muhonen, D J Fisher, H D Nguyen, J C Ehrhardt, B C Wen, J F Doornbos, D H Hussey
American Journal of Neuroradiology Jun 1994, 15 (6) 1053-1061;
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