Use of a decision-analytic model to support the use of a new oral US contrast agent in patients with abdominal pain

Rationale and Objectives. The authors performed this study to compare the c ost and diagnostic abilities of ultrasound (US) performed with and without the use of an oral contrast material recently approved by the U.S. Food and Drug Administration. Materials and Methods. An interactive decision-analytic model was construct ed to compare US performed with and without contrast material (SonoRx, Brac co Diagnostics) for the evaluation of patients with abdominal pain who were suspected of having pancreatic disease. The model considered all resources that might be used to evaluate a patient suspected of having pancreatic di sease leg, US, computed tomography [CT], endoscopic retrograde cholangiopan creatography, fine-needle aspiration biopsy, and open biopsy). The literatu re and an expert panel were the clinical data sources. Cost estimates were based on Medicare and non-Medicare reimbursements. The primary cost-effecti veness measure was the cost to achieve a diagnosis. Results. SonoRx-enhanced US was less expensive than unenhanced US ($714 vs $808, respectively, with Medicare costs; $1,612 vs $1,878. respectively, wi th non-Medicare costs) and as effective (0.785 vs 0.782, respectively). Son oRx-enhanced US was more cost-effective than unenhanced US ($909 vs $1,034, respectively, with Medicare costs; $2,052 vs $2,401, respectively, with no n-Medicare costs). This relationship was maintained throughout extensive se nsitivity analyses. Conclusion. SonoRx-enhanced US is more cost-effective than unenhanced US, p rimarily because it avoids the need for CT. CT may be avoided owing to the higher probability of obtaining optimal US scans with oral contrast materia l.