Abstract
Purpose
The objective of our study was to analyze the health economic impact of ferucarbotran-enhanced magnetic resonance imaging (MRI) in the diagnosis of hepatic colorectal cancer metastases based on observed changes in medical management.
Materials and methods
A decision tree simulating a patient’s medical management was designed, comparing two scenarios: contrast-enhanced spiral computed tomography-based vs ferucarbotran-enhanced MRI-based (Resovist®, Bayer Schering Pharma AG, Germany) diagnosis. A clinical trial in patients with presumed liver metastases (n = 36) provided data on clinical decisions regarding the medical management options in relation to diagnostic outcomes: resection, chemotherapy, or best supportive care. A “gold standard” was established afterward, combining all the available clinical, imaging, laboratory, and pathology findings. A multidisciplinary panel formed by a hepatologist, a liver surgeon, and an interventional radiologist decided on the recommended medical management for each patient. Costs of medical resources associated with each management option (all expressed in Euro) were obtained from the public health insurance (average European values). Life expectancies for the different options were obtained from literature.
Results
Despite an initial extra cost of €338, a significant net saving of €1,443 was obtained with ferucarbotran-enhanced MRI mainly because of avoiding unnecessary surgery. There was no significant difference in the predicted life expectancy between both arms, despite the large difference in medical decision.
Conclusion
In this comparative medical decision analysis, it was shown that ferucarbotran-enhanced MRI has the potential to improve medical management and save health care costs.
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Notes
“Gold standard” is the term used by the authors of Lencioni et al. [10]. For this reason, we apply this term as well. The scope of this “gold standard” is what is usually termed “Standard of Truth.”
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Acknowledgment
This research project was supported by an unrestricted grant from Bayer Schering Pharma AG.
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Annemans, L., Lencioni, R., Warie, H. et al. Health economic evaluation of ferucarbotran-enhanced MRI in the diagnosis of liver metastases in colorectal cancer patients. Int J Colorectal Dis 23, 77–83 (2008). https://doi.org/10.1007/s00384-007-0350-7
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DOI: https://doi.org/10.1007/s00384-007-0350-7