Evidence-based cardiovascular magnetic resonance cost-effectiveness calculator for the detection of significant coronary artery disease
Posted on 2022-01-06 - 04:28
Abstract Background Although prior reports have evaluated the clinical and cost impacts of cardiovascular magnetic resonance (CMR) for low-to-intermediate-risk patients with suspected significant coronary artery disease (CAD), the cost-effectiveness of CMR compared to relevant comparators remains poorly understood. We aimed to summarize the cost-effectiveness literature on CMR for CAD and create a cost-effectiveness calculator, useable worldwide, to approximate the cost-per-quality-adjusted-life-year (QALY) of CMR and relevant comparators with context-specific patient-level and system-level inputs. Methods We searched the Tufts Cost-Effectiveness Analysis Registry and PubMed for cost-per-QALY or cost-per-life-year-saved studies of CMR to detect significant CAD. We also developed a linear regression meta-model (CMR Cost-Effectiveness Calculator) based on a larger CMR cost-effectiveness simulation model that can approximate CMR lifetime discount cost, QALY, and cost effectiveness compared to relevant comparators [such as single-photon emission computed tomography (SPECT), coronary computed tomography angiography (CCTA)] or invasive coronary angiography. Results CMR was cost-effective for evaluation of significant CAD (either health-improving and cost saving or having a cost-per-QALY or cost-per-life-year result lower than the cost-effectiveness threshold) versus its relevant comparator in 10 out of 15 studies, with 3 studies reporting uncertain cost effectiveness, and 2 studies showing CCTA was optimal. Our cost-effectiveness calculator showed that CCTA was not cost-effective in the US compared to CMR when the most recent publications on imaging performance were included in the model. Conclusions Based on current world-wide evidence in the literature, CMR usually represents a cost-effective option compared to relevant comparators to assess for significant CAD.
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Pandya, Ankur; Yu, Yuan-Jui; Ge, Yin; Nagel, Eike; Kwong, Raymond Y.; Bakar, Rafidah Abu; et al. (2022). Evidence-based cardiovascular magnetic resonance cost-effectiveness calculator for the detection of significant coronary artery disease. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.5780014.v1
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AUTHORS (22)
AP
Ankur Pandya
YY
Yuan-Jui Yu
YG
Yin Ge
EN
Eike Nagel
RK
Raymond Y. Kwong
RB
Rafidah Abu Bakar
JG
John D. Grizzard
AM
Alexander E. Merkler
NN
Ntobeko Ntusi
SP
Steffen E. Petersen
NR
Nina Rashedi
JS
Juerg Schwitter
JS
Joseph B. Selvanayagam
JW
James A. White
JC
James Carr
SR
Subha V. Raman
OS
Orlando P. Simonetti
CB
Chiara Bucciarelli-Ducci
LS
Lilia M. Sierra-Galan
VF
Victor A. Ferrari