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

Journal Article · Wed Jun 01 04:00:00 EDT 1994 · AJNR. American Journal of Neuroradiology

OSTI ID:50618

Mayr, N A; Yuh, W T.C.; Muhonen, M G; Fisher, D J; Nguyen, H D; Ehrhardt, J C; Wen, B C; Doornbos, J F; Hussey, D H ^[1]

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1. Univ. of Iowa College of Medicine, Iowa City, IA (United States)

To investigate the cost-effectiveness of high-dose MR contrast studies in the management of brain metastases. 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. A total of 3 craniotomies ($22800 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 $70644. 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 $11154 for 2 separate injections completed in 2 separate visits. The cost savings in management (diagnosis and treatment) therefore ranged from $59490 to $61518 for all patients and from $2203 to $2278 per patient. 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. 43 refs., 2 tabs.

• OSTI ID: 50618
• Journal Information: AJNR. American Journal of Neuroradiology, Journal Name: AJNR. American Journal of Neuroradiology Journal Issue: 6 Vol. 15; ISSN 0195-6108; ISSN AAJNDL
• Country of Publication: United States
• Language: English

Related Subjects

55 BIOLOGY AND MEDICINE
BASIC STUDIES
BRAIN
CONTRAST MEDIA
COST BENEFIT ANALYSIS
DIAGNOSTIC USES
DOSE RATES
MAGNETIC RESONANCE
METASTASES