HEOR aspects

Health Economics Outcomes Research

High precision in detecting, localizing and characterizing liver lesions is important for further treatment decisions, which may have consequences on the prognosis of patient’s life expectancy and quality. More accurate imaging may also influence economic consequences, as improving pre-operative planning and avoidance of unnecessary surgery.
C.J. Zech et al.¹ compared multi detector CT (MDCT), extracellular contrast media enhanced-MRI (ECCM-MRI) and Primovist^® enhanced-MRI (PV-MRI) regarding the exclusion of malignancies, therapeutic decision-finding and reduction of further imaging. The costs for modification of surgical procedures and unnecessary surgery were compared when using each of this modalities as initial imaging method.

Initial Primovist^®-enhanced MRI can help exclude malignancy

The decision-tree model for the evaluation of patients with a history of colorectal cancer and with known or suspected metachronous liver metastases showed that malignancy could be excluded in a greater proportion of patients using initial Primovist^®-enhanced MRI compared with initial ECCM-MRI or MDCT.
Hepatocyte-specific enhancement provides confidence in excluding malignancy to avoid unnecessary surgery – an important cost saver (Figure 1).

Initial Primovist^®-enhanced MRI can improve therapeutic decision-making

The model showed that initial Primovist^®-enhanced MRI allowed better pre-operative planning with less intraoperative changes and identified more inoperable situations – helping to reducing costs (Figure 2).

Initial Primovist^®-enhanced MRI can reduce need for further imaging

By providing more accurate information during the initial scan, Primovist^® can reduce the need for further diagnostic procedures – hence reducing costs (Figure 3).

C.J. Zech et al.¹demonstrated that PV-MRI improves pre-operative planning and decreases intra-operative changes in planning. This leads to cost savings due to shorter operative time, benefits for patients due to shorter anaesthesia time, and higher rate of avoidance of unnecessary surgical procedures. If the cost savings due to better pre-operative planning are taken into account, PV-MRI as initial imaging investigation has costs similar to MD-CT, and is cost-saving compared to extracellular contrast media enhanced-MRI (ECCM-MRI).

References:
1. Zech C. Eur Radiol. 2009 Jun;19 Suppl 3:S753-63.
www.ncbi.nlm.nih.gov/pubmed/19484243 . Accessed January 20th 2011