Cost-effectiveness analysis of new generation coronary CT scanners for difficult-to-image patients
L. T. Burgers (),
W. K. Redekop (),
M. J. Al (),
S. K. Lhachimi (),
N. Armstrong (),
C. Rothery (),
M. Westwood () and
J. L. Severens ()
Additional contact information
L. T. Burgers: Erasmus University Rotterdam
W. K. Redekop: Erasmus University Rotterdam
M. J. Al: Erasmus University Rotterdam
S. K. Lhachimi: Erasmus University Rotterdam
N. Armstrong: Kleijnen Systematic Reviews Ltd
C. Rothery: University of York
M. Westwood: Kleijnen Systematic Reviews Ltd
J. L. Severens: Erasmus University Rotterdam
The European Journal of Health Economics, 2017, vol. 18, issue 6, 731-742
Abstract Aims New generation dual-source coronary CT (NGCCT) scanners with more than 64 slices were evaluated for patients with (known) or suspected of coronary artery disease (CAD) who are difficult to image: obese, coronary calcium score > 400, arrhythmias, previous revascularization, heart rate > 65 beats per minute, and intolerance of betablocker. A cost-effectiveness analysis of NGCCT compared with invasive coronary angiography (ICA) was performed for these difficult-to-image patients for England and Wales. Methods and results Five models (diagnostic decision model, four Markov models for CAD progression, stroke, radiation and general population) were integrated to estimate the cost-effectiveness of NGCCT for both suspected and known CAD populations. The lifetime costs and effects from the National Health Service perspective were estimated for three strategies: (1) patients diagnosed using ICA, (2) using NGCCT, and (3) patients diagnosed using a combination of NGCCT and, if positive, followed by ICA. In the suspected population, the strategy where patients only undergo a NGCCT is a cost-effective option at accepted cost-effectiveness thresholds. The strategy of using NGCCT in combination with ICA is the most favourable strategy for patients with known CAD. The most influential factors behind these results are the percentage of patients being misclassified (a function of both diagnostic accuracy and the prior likelihood), the complication rates of the procedures, and the cost price of a NGCCT scan. Conclusion The use of NGCCT might be considered cost-effective in both populations since it is cost-saving compared to ICA and generates similar effects.
Keywords: Cost-effectiveness; CT scanner; Coronary artery disease; Radiation; Imaging (search for similar items in EconPapers)
References: View references in EconPapers View complete reference list from CitEc
Citations: Track citations by RSS feed
Downloads: (external link)
http://link.springer.com/10.1007/s10198-016-0824-z Abstract (text/html)
Access to the full text of the articles in this series is restricted.
This item may be available elsewhere in EconPapers: Search for items with the same title.
Export reference: BibTeX
RIS (EndNote, ProCite, RefMan)
Persistent link: https://EconPapers.repec.org/RePEc:spr:eujhec:v:18:y:2017:i:6:d:10.1007_s10198-016-0824-z
Ordering information: This journal article can be ordered from
http://www.springer. ... cs/journal/10198/PS2
Access Statistics for this article
The European Journal of Health Economics is currently edited by J.-M.G.v.d. Schulenburg
More articles in The European Journal of Health Economics from Springer, Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ) Contact information at EDIRC.
Bibliographic data for series maintained by Sonal Shukla ().