An Economic Analysis of Strategies for the Use of Contrast Media for Diagnostic Cardiac Catheterization

Brendan J. Barrett, Patrick S. Parfrey, Robert N. Foley and Allan S. Detsky

Medical Decision Making, 1994, vol. 14, issue 4, 325-335

Abstract: A decision tree model was used to estimate the incremental cost per quality-adjusted life year (QALY) of low- as opposed to high-osmolality contrast media for cardiac angiography. Analyses were done from the viewpoints of a third-party payer and society using data from a randomized trial and the literature. Assuming low-osmolality media reduce the risk of myocardial infarction and stroke, the incremental cost per QALY gained with these media is $17,264 in high-risk or $47,874 in low-risk patients for a third-party payer. From a societal viewpoint, the corresponding costs are $649 and $35,509. These estimates are sensitive to the cost and volume of the contrast medium employed and to the estimate of reduction in severe adverse events with low-osmolality media. The authors conclude that, in the context of restricted budgets, limiting the use of low-osmolality media to high-risk patients is justifiable, as the incremental cost per QALY in high-risk patients may be reasonable and it is not certain that low-osmolality media prevent severe or fatal events. A considerable reduction in the cost per QALY gained is possible by minimizing the volume of contrast medium used. Key words: contrast media; low-osmolality; high-osmolality; cardiac angiography; cost-utility; cost-benefit; cost-effectiveness; economic analysis. (Med Decis Making 1994;14:325- 335)

Date: 1994
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:14:y:1994:i:4:p:325-335

DOI: 10.1177/0272989X9401400403

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