Title: The cost effectiveness of 123I-FP-CIT SPECT imaging in patients with an uncertain clinical diagnosis of parkinsonism
Authors: Van Laere, Koen ×
Everaert, Ludwig
Annemans, Lieven
Gonce, Michel
Vandenberghe, Wim
Vander Borght, Thierry #
Issue Date: Jul-2008
Series Title: European Journal of Nuclear Medicine and Molecular Imaging vol:35 issue:7 pages:1367-1376
Abstract: PURPOSE: (123)I-N-omega-fluoropropyl-2-beta-carboxymethoxy-3beta-(4-iodophenyl)nortropane ((123)I-FP-CIT) Single-photon emission computed tomography (SPECT) has been suggested to be a useful diagnostic adjunct in patients with clinically uncertain parkinsonism. We developed a pharmaco-economic (PE) model, evaluating the cost effectiveness of adding (123)I-FP-CIT SPECT to the diagnostic workup. As the model was developed before application of the diagnostic technique in real practice, a predictive validity assessment was performed based on data from a large nationwide patient registry in these patients. METHODS: A PE model, using a Markov state transition model, was created, based on literature-derived and clinical expert panel data. Effects were expressed as adequately treated years (ATY). Key input data were compared to the real-life patterns in a nationwide multi-centre clinical setting, based on a complete national registry of 1,701 consecutive patients. The change in initial diagnosis and alteration of management of the patient after SPECT were registered. RESULTS: In the PE model, it was calculated that management would change in 48.5% of patients by SPECT and that, over a 5-year period, 1.2 ATYs could be gained at a yearly additional cost of 72 euro. From the studied 1,701 patients, nigrostriatal degeneration was observed in 59.8%, the initial diagnosis was changed in 51.5%, management was altered in 49%, and cost effectiveness was increased to 358 euro per ATY. CONCLUSION: Good correspondence between assumed and observed changes in patient management was found, indicating that (123)I-FP-CIT SPECT is influential in diagnosis and management of patients with uncertain clinical diagnosis of parkinsonism. This can be achieved at a marginal added cost to the health insurance and leads to a significant gain in ATY.
ISSN: 1619-7070
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Research Group Experimental Neurology
Nuclear Medicine & Molecular Imaging
Laboratory for Parkinson Research
× corresponding author
# (joint) last author

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