Skip to main content Accessibility help
×
Home
Hostname: page-component-65dc7cd545-nrv4r Total loading time: 0.228 Render date: 2021-07-23T20:39:13.893Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Assessing short-term effects and costs at an early stage of innovation: The use of positron emission tomography on radiotherapy treatment decision making

Published online by Cambridge University Press:  09 April 2008

Raphaël Remonnay
Affiliation:
GATE CNRS-UMR 5824 and Centre Léon Bérard
Magali Morelle
Affiliation:
GATE CNRS-UMR 5824 and Centre Léon Bérard
Pascal Pommier
Affiliation:
Regional Cancer Center Léon Bérard
Francesco Giammarile
Affiliation:
University of Lyon and Centre Hospitalier Lyon-Sud
Marie-Odile Carrère
Affiliation:
GATE CNRS-UMR 5824

Abstract

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 €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 €425 and €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.

Type
GENERAL ESSAYS
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below.

References

1. Alzahouri, K, Lejeune, C, Woronoff-Lemsi, MC, Arveux, P, Guillemin, F. Cost-effectiveness analysis of strategies introducing FDG-PET into the mediastinal staging of non-small-cell lung cancer from the French healthcare system perspective. Clin Radiol. 2005;60:479492.CrossRefGoogle ScholarPubMed
2. Bradbury, I, Bonell, E, Boynton, J, et al. Positron emission tomography (PET) imaging in cancer management. Health Technology Report 2. Glasgow: Health Technology Board for Scotland; 2002.Google Scholar
3. Bradbury, I, Facey, K, Laking, G, Sharp, P. Investing in new technology: The PET experience. Br J Cancer. 2002;89:224227.CrossRefGoogle Scholar
4. Chuck, A, Jacobs, P, Logus, JW, et al. Marginal cost of operating a positron emission tomography centre in a regulatory environment. Int J Technol Assess Health Care. 2005;21:442451.CrossRefGoogle Scholar
5. Collège des Economistes dela Santé (French Health Economics Association). French guidelines for the economic evaluation of health care technologies. 2004. Available at: www.ces-asso.org.Google Scholar
6. Collège des Economistes de la Santé. Guide méthodologique pour l'évaluation économique des stratégies de santé. Paris: CES; 2003.Google Scholar
7. Drummond, M, Sculpher, MJ, Torrance, G, O'Brien, B, Stoddart, G. Methods for the economic evaluation of health care programmes, 3rd ed. Oxford: Oxford University Press; 2005.Google Scholar
8. Fédération nationale des centres de lutte contre le cancer, Société française de biophysique et médecine nucléaire, La Ligue, Fédération hospitalière de France, Fédération française de cancérologie. Standards, Options et Recommandations pour l'utilisation de la tomographie par émission de positons au [18F]—FDG (PET-FDG) en cancérologie. Paris: FNCLCC; 2003.Google Scholar
9. Gambhir, SS, Hoh, CK, Phelps, ME, Madar, I, Maddahi, J. Decision trees sensitivity analysis for cost-effectiveness of FDG-PET in the staging and management of non-small cell lung carcinoma. J Nucl Med. 1996;7:14281436.Google Scholar
10. Gregoire, V, Haustermans, K, Geets, X, Roels, S, Lonneux, M. PET-based treatment planning in radiotherapy: A new standard? J Nucl Med. 2007;48 (Suppl 1):68s77s.Google ScholarPubMed
11. Gugiatti, A, Grimaldi, A, Rossetti, C, et al. Economic analyses on the use of positron emission tomography for the work-up of solitary pulmonary nodules and for staging patients with non-small-cell-lung-cancer in Italy. Q J Nucl Med Mol Imaging. 2004;48:4961.Google Scholar
12. IARC. 2006, Globocan database. Available at: http://www-dep.iarc.fr/.Google Scholar
13. Juweid, ME, Cheson, BD. Positron-emission tomography and assessment of cancer therapy. N Engl J Med. 2006;354:496507.CrossRefGoogle ScholarPubMed
14. Kelly, RF, Tran, T, Holmstrom, A, Murar, J, Segurola, RJ Jr. Accuracy and cost-effectiveness of [18F]-2-fluoro-deoxy-D-glucose-positron emission tomography scan in potentially resectable non-small cell lung cancer. Chest. 2004;125:14131423.CrossRefGoogle Scholar
15. Klose, T, Leidl, R, Buchmann, I, Brambs, HJ, Reske, SN. Primary staging of lymphomas: Cost-effectiveness of FDG-PET versus computed tomography. Eur J Nucl Med. 2000;27:14571464.CrossRefGoogle ScholarPubMed
16. Kosuda, S, Ichihara, K, Watanabe, M, Kobayashi, H, Kusano, S. Decision tree sensitivity analysis for cost-effectiveness of whole-body FDG PET in the management of patients with non small-cell-lung carcinoma in Japan. Ann Nucl Med. 2002;19:263271.CrossRefGoogle Scholar
17. Kosuda, S, Ichilara, K, Watanabe, M, Kobayashi, H, Kusano, S. Decision tree sensitivity analysis for cost-effectiveness of chest 2-fluoro-2-D -[18F] Fluorodeoxyglucose positron emission tomography in patients with pulmonary nodules (non small cell lung carcinoma) in Japan. Chest. 2000;178:346353.CrossRefGoogle Scholar
18. Ministère de la Santé et de la Protection sociale. Arrêté du 28 mai 2004 fixant l'indice de besoins afférent aux appareils de diagnostic utilisant l'émission de radioéléments artificiels (caméra à scintillation munie d'un détecteur d'émission de positons en coïncidence, tomographe à émission de positons, caméra à positons). Journal Officiel. 2004;144:11318.Google Scholar
19. Nguyen, VH, Peloquin, S, Lacasse, Y. Cost-effectiveness of positron emission tomography for the management of potentially operable non-small cell lung cancer in Quebec. Can Respir J. 2005;12:1925.CrossRefGoogle Scholar
20. Scott, WJ, Shepherd, J, Gambhir, SS. Cost-effectiveness of FDG-PET for staging non-small cell lung cancer: A decision analysis. Ann Thorac Surg. 1998;66:18761883.CrossRefGoogle Scholar
21. Sloka, JS, Hollett, PD, Mathews, M. Cost-effectiveness of positron emission tomography for non-small cell lung carcinoma in Canada. Med Sci Monit. 2004;10:MT73MT80.Google Scholar
22. Valk, PE, Pounds, TR, Tesar, RD, Hopkins, DM, Haseman, MK. Cost-effectiveness of PET imaging in clinical oncology. Nucl Med Biol. 1996;23:737743.CrossRefGoogle ScholarPubMed
23. Verboom, P, van Tinteren, H, Hoekstra, OS, et al. Cost-effectiveness of FDG-PET in staging non-small cell lung cancer: The PLUS study. Eur J Nucl Med Mol Imaging. 2003;11:14441449.CrossRefGoogle Scholar
24. Von Schulthess, GK, Steinert, HC, Dummer, R, Weder, W. Cost-effectiveness of whole-body PET imaging in non-small cell lung cancer and malignant melanoma. Acad Radiol. 1998;(Suppl 2):S300S302.CrossRefGoogle ScholarPubMed
13
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Assessing short-term effects and costs at an early stage of innovation: The use of positron emission tomography on radiotherapy treatment decision making
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Assessing short-term effects and costs at an early stage of innovation: The use of positron emission tomography on radiotherapy treatment decision making
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Assessing short-term effects and costs at an early stage of innovation: The use of positron emission tomography on radiotherapy treatment decision making
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *