Health economic aspects of evaluation with diffusion weighted MR and MR colonography compared to standard evaluation with colonoscopy and CT before rectal cancer surgery

TY - JOUR

T1 - Health economic aspects of evaluation with diffusion weighted MR and MR colonography compared to standard evaluation with colonoscopy and CT before rectal cancer surgery

AU - Achiam, Michael P

AU - Kjellberg, Jakob

AU - Rosenberg, Jacob

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background Colorectal cancer is a frequent type of cancer, and with the risk of synchronous disease, the need for a complete staging leads to an extensive and costly preoperative diagnostic evaluation. Previously we described a total preoperative evaluation using magnetic resonance (MR) colonography and diffusion-weighted MR of the liver. Purpose To compare the economic aspects of this modality with the standard evaluation in an analysis of the different cost drivers. Material and Methods Based on the results from previous studies, two calculations were performed, a theoretical cost calculation and a practical cost calculation. The cost drivers utilized are an average cost based on the cost of all procedures and diagnostic modalities performed in hospitalized patients (DRG) and outpatients (DAGS [Danish outpatient grouping system]) in Denmark. Results The total cost for a full colorectal evaluation and computed tomography (CT) scan of the thorax/abdomen was less for the new modality group in all theoretical models proposed; €225 using model A, €322 using model B, and €383 using model C. Using results from previous studies, the actual difference and the potential difference in cost between the two preoperative diagnostic modalities per patient were €312 and €712, respectively. Conclusion This cost analysis shows the cost effectiveness of the new modality as the future standard preoperative diagnostic work-up by reducing total cost and by having a higher sensitivity and completion rate.

AB - Background Colorectal cancer is a frequent type of cancer, and with the risk of synchronous disease, the need for a complete staging leads to an extensive and costly preoperative diagnostic evaluation. Previously we described a total preoperative evaluation using magnetic resonance (MR) colonography and diffusion-weighted MR of the liver. Purpose To compare the economic aspects of this modality with the standard evaluation in an analysis of the different cost drivers. Material and Methods Based on the results from previous studies, two calculations were performed, a theoretical cost calculation and a practical cost calculation. The cost drivers utilized are an average cost based on the cost of all procedures and diagnostic modalities performed in hospitalized patients (DRG) and outpatients (DAGS [Danish outpatient grouping system]) in Denmark. Results The total cost for a full colorectal evaluation and computed tomography (CT) scan of the thorax/abdomen was less for the new modality group in all theoretical models proposed; €225 using model A, €322 using model B, and €383 using model C. Using results from previous studies, the actual difference and the potential difference in cost between the two preoperative diagnostic modalities per patient were €312 and €712, respectively. Conclusion This cost analysis shows the cost effectiveness of the new modality as the future standard preoperative diagnostic work-up by reducing total cost and by having a higher sensitivity and completion rate.

KW - Colon

KW - Colonoscopy

KW - Cost-Benefit Analysis

KW - Denmark

KW - Diffusion Magnetic Resonance Imaging

KW - Humans

KW - Magnetic Resonance Imaging

KW - Rectal Neoplasms

KW - Sensitivity and Specificity

KW - Tomography, X-Ray Computed

KW - Comparative Study

KW - Journal Article

U2 - 10.1177/0284185116653281

DO - 10.1177/0284185116653281

M3 - Journal article

C2 - 27307026

SN - 0284-1851

VL - 58

SP - 435

EP - 441

JO - Acta Radiologica

JF - Acta Radiologica

IS - 4

ER -