MISC

2003年12月

Medical economics of whole-body FDG PET in patients suspected of having non-small cell lung carcinoma - Reassessment based on the revised Japanese national insurance reimbursement system

ANNALS OF NUCLEAR MEDICINE
  • K Abe
  • ,
  • S Kosuda
  • ,
  • S Kusano

17
8
開始ページ
649
終了ページ
655
記述言語
英語
掲載種別
DOI
10.1007/BF02984970
出版者・発行元
JAPANESE SOCIETY NUCLEAR MEDICINE

Focusing on the savings expected from the revised Japanese national insurance reimbursement system in the management of patients suspected of having non-small cell lung carcinoma (NSCLC), cost-effectiveness was assessed using decision tree sensitivity analysis on the basis of the 2 competing strategies of whole-body FDG PET (WB-PET) and conventional imaging (CI). Methods: A WB-PET strategy that models dependence upon chest FDG PET scan, WB-PET scan, and brain MR imaging with contrast was designed. The cost of a FDG PET examination was updated and determined to be US$625.00. The CI strategy involves a combination of conventional examinations, such as abdominal CT with contrast, brain MR imaging with contrast, and a whole-body bone scan. A simulation of 1,000 patients suspected of having NSCLC (Stages I to IV) was created for each strategy using a decision tree and baselines of other relevant variables cited from published data. Results: By using the WB-PET strategy in place of the CI strategy for the management of patients suspected of having NSCLC in hospitals with an NSCLC prevalence of 75%, the cost saving (CS) for each patient would be US$697.69 for an M1 prevalence of 20% and US$683.52 for an M1 prevalence of 40%, but the CS gradually decreases as the NSCLC prevalence increases. The break-even point requires less than an 80% prevalence in order for the WB-PET strategy to gain life expectancy (LE) per patient. By using the WB-PET strategy in place of the Cl strategy for the management of patients suspected of having NSCLC in hospitals with an NSCLC prevalence of 75%, the gain in LE for each patient would be 0.04 years (11.06 vs. 11.02 years) for an M1 prevalence of 20% and 0.10 years (10.13 vs. 10.03 years) for an M1 prevalence of 40%. The maximum cost of a PET study without losing LE would be US$1322.68 per patient for prevalences of 75% NSCLC and 20% M1 disease. Conclusions: The present study quantitatively showed WB-PET, employed in place of CI for managing NSCLC patients, to be cost-effective in the Japanese revised insurance reimbursement system. However, the present cost is very low from the industrial viewpoint.

リンク情報
DOI
https://doi.org/10.1007/BF02984970
CiNii Articles
http://ci.nii.ac.jp/naid/10012161623
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/14971606
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000188593600004&DestApp=WOS_CPL
ID情報
  • DOI : 10.1007/BF02984970
  • ISSN : 0914-7187
  • CiNii Articles ID : 10012161623
  • PubMed ID : 14971606
  • Web of Science ID : WOS:000188593600004

エクスポート
BibTeX RIS