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.
Original language | English (US) |
---|---|
Pages (from-to) | 325-335 |
Number of pages | 11 |
Journal | Medical Decision Making |
Volume | 14 |
Issue number | 4 |
DOIs | |
State | Published - Oct 1994 |
Keywords
- cardiac angiography
- contrast media
- cost-benefit
- cost-effectiveness
- cost-utility
- economic analysis
- high-osmolality
- low-osmolality