Document Detail


Assessing short-term effects and costs at an early stage of innovation: the use of positron emission tomography on radiotherapy treatment decision making.
MedLine Citation:
PMID:  18400125     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Positron emission tomography (PET) is an innovative imaging tool. Associated with computed tomography (CT), it allows a better definition for the tumor volume for radiotherapy, compared with CT only. The aim of this study was to assess the effects of PET on resource allocation (costs and savings) and on the choice of the following treatment in radiotherapy. METHODS: In 2004 and 2005, 209 patients were enrolled (97 patients with Hodgkin's disease and 112 with non-small cell lung cancer) in a national study conducted in eight hospitals. Two treatment decisions made on the basis of CT only or CT associated with PET, were compared in a prospective study where each subject was his/her own control. The direct medical cost of using PET was assessed by microcosting, using data collected from specific questionnaires. The costs of new tests and the costs and savings associated with changes in the chosen treatment were calculated on the basis of reimbursement rates. RESULTS: The mean cost of using PET was approximately euro 800 per patient (50 percent for the radionuclide 18F-FDG [2-[18F]fluoro-2-deoxy-D-glucose]). Radiotherapy treatments were modified for 10 percent of patients with Hodgkin's disease versus 40 percent of patients with lung cancer. Overall, the use of PET induced both increases and decreases in the mean cost per patient: the net effect was a euro 425 and euro 931 cost increase in lung cancer and Hodgkin's disease, respectively. CONCLUSIONS: The use of PET for radiotherapy decision making seems more valuable for lung cancer than for Hodgkin's disease, both in terms of costs and changes in radiotherapy treatment. This result might help policy makers for prioritization.
Authors:
Raphaël Remonnay; Magali Morelle; Pascal Pommier; Francesco Giammarile; Marie-Odile Carrère
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of technology assessment in health care     Volume:  24     ISSN:  0266-4623     ISO Abbreviation:  Int J Technol Assess Health Care     Publication Date:  2008  
Date Detail:
Created Date:  2008-04-10     Completed Date:  2008-07-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508113     Medline TA:  Int J Technol Assess Health Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  212-20     Citation Subset:  IM    
Affiliation:
GATE CNRS-UMR 5824, Lyon, France. remonnay@lyon.fnclcc.fr
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MeSH Terms
Descriptor/Qualifier:
Carcinoma, Non-Small-Cell Lung / economics*,  radiotherapy*
Costs and Cost Analysis
Decision Making
Female
Fluorodeoxyglucose F18 / economics
Hodgkin Disease / economics*,  radiotherapy*
Humans
Lung Neoplasms / economics*,  radiotherapy*
Male
Positron-Emission Tomography
Radiopharmaceuticals / economics
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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