PMID- 30732489
OWN - NLM
STAT- MEDLINE
DCOM- 20190916
LR  - 20190916
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 22
IP  - 5
DP  - 2019 May
TI  - Cost-impact of cardiac magnetic resonance imaging with Fast-SENC compared to 
      SPECT in the diagnosis of coronary artery disease in the U.S.
PG  - 430-438
LID - 10.1080/13696998.2019.1580713 [doi]
AB  - AIMS: The purpose of this study is to assess the economic cost differences and 
      the associated treatment resource changes between the developing coronary artery 
      disease (CAD) diagnostic tool fast strain-encoded cardiac imaging (Fast-SENC) and 
      the current commonly used stress test single-photon emission computed tomography 
      (SPECT). MATERIALS AND METHODS: A "payer perspective" model was created first, 
      consisting of long-term and short-term components that used a hypothetical cohort 
      of patients of average age (60.8 years) presenting with chest pain and suspected 
      CAD to assess cost-impact. A cost impact model was then built that assessed 
      likely savings from a "hospital perspective" from substituting Fast-SENC for a 
      portion of SPECTs assuming an average number of annual SPECT tests performed in 
      US hospitals. RESULTS: In the payer model, using Fast-SENC followed by coronary 
      angiography (CA) and percutaneous coronary intervention (PCI) treatment when 
      necessary is less costly than the SPECT method when considering both direct and 
      indirect costs of testing. Expected costs of the Fast-SENC were between $2,510 
      and $2,632 per correct diagnosis, while expected costs for the SPECT were between 
      $3,157 and $4,078. Fast-SENC reduced false positives by 50% and false negatives 
      by 86%, generating additional cost savings. The hospital model showed total costs 
      per CAD patient visit of $825 for SPECT and $376 for Fast-SENC. LIMITATIONS: 
      Limitations of this study are that clinical data are sourced from other published 
      clinical trials on how CAD diagnostic strategies impact clinical outcome, and 
      that necessary assumptions were made which impact health outcomes. CONCLUSION: 
      The lower cost, higher sensitivity and specificity rates, and faster, less 
      burdensome process for detecting CAD patients make Fast-SENC a more capable and 
      economically beneficial stress test than SPECT. The payer model and hospital 
      model demonstrate an alignment between payer and provider economics as Fast-SENC 
      provides monetary savings for patients and resource benefits for hospitals.
FAU - Stojanovic, Ivana
AU  - Stojanovic I
AD  - a Avalon Health Economics , Morristown , NJ , USA.
FAU - Schneider, John E
AU  - Schneider JE
AD  - a Avalon Health Economics , Morristown , NJ , USA.
FAU - Cooper, Jacie
AU  - Cooper J
AD  - a Avalon Health Economics , Morristown , NJ , USA.
LA  - eng
PT  - Journal Article
DEP - 20190315
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
SB  - IM
MH  - Coronary Artery Disease/*diagnosis/diagnostic imaging
MH  - Costs and Cost Analysis
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging/*economics/*methods/standards
MH  - Male
MH  - Tomography, Emission-Computed, Single-Photon/*economics/standards
OTO - NOTNLM
OT  - C50
OT  - Coronary artery disease
OT  - I15
OT  - cardiac magnetic resonance imaging
OT  - coronary heart disease
OT  - cost impact analysis
OT  - hospital value analysis
EDAT- 2019/02/09 06:00
MHDA- 2019/09/17 06:00
CRDT- 2019/02/09 06:00
PHST- 2019/02/09 06:00 [pubmed]
PHST- 2019/09/17 06:00 [medline]
PHST- 2019/02/09 06:00 [entrez]
AID - 10.1080/13696998.2019.1580713 [doi]
PST - ppublish
SO  - J Med Econ. 2019 May;22(5):430-438. doi: 10.1080/13696998.2019.1580713. Epub 2019 
      Mar 15.