Rl. Bree et al., Use of a decision-analytic model to support the use of a new oral US contrast agent in patients with abdominal pain, ACAD RADIOL, 8(3), 2001, pp. 234-242
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.