Health economic aspects of evaluation with diffusion weighted MR and MR colonography compared to standard evaluation with colonoscopy and CT before rectal cancer surgery. (April 2017)

• Record Type: Journal Article
• Authors: Achiam, Michael P; Kjellberg, Jakob; Rosenberg, Jacob
• Is Part Of: Acta radiologica. Volume 58:Number 4(2017:Apr.)
• Page Start: 435
• Page End: 441
• Publication Date: 2017-04
• Subjects: Health economic -- cost -- rectal cancer -- magnetic resonance imaging (MR) -- computed tomography (CT) -- colonography; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185116653281
• Languages: English
• ISSNs: 0284-1851

Abstract

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.