Access to cardiac PET/CT by sarcoidosis patients and cost-effectiveness analysis of cardiac PET/MR compared to the standard of care.

Autor: Subramanian K; Division of Molecular Imaging & Therapeutics, Department of Radiology, Weill Cornell Medicine, New York, NY, United States of America. Electronic address: krs9089@nyp.org., Martinez J; Division of Molecular Imaging & Therapeutics, Department of Radiology, Weill Cornell Medicine, New York, NY, United States of America., Osborne JR; Division of Molecular Imaging & Therapeutics, Department of Radiology, Weill Cornell Medicine, New York, NY, United States of America., Nicholson S; Department of Policy Analysis and Management, Sloan, Cornell Institute for Public Affairs, New York, NY, United States of America., Van Parys J; Department of Economics, Hunter College, City University of New York, New York, NY, United States of America., Singh P; Department of Cardiology, Weill Cornell Medicine, New York, NY, United States of America., An A; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States of America., Heise R; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States of America., Al-Hakim T; Foundation for Sarcoidosis Research, Chicago, IL, United States of America., Buchanan M; Foundation for Sarcoidosis Research, Chicago, IL, United States of America., Youn T; Division of Molecular Imaging & Therapeutics, Department of Radiology, Weill Cornell Medicine, New York, NY, United States of America.
Jazyk: angličtina
Zdroj: Clinical imaging [Clin Imaging] 2023 Feb; Vol. 94, pp. 50-55. Date of Electronic Publication: 2022 Dec 02.
DOI: 10.1016/j.clinimag.2022.11.021
Abstrakt: Importance: Cardiac sarcoidosis is associated with a high mortality rate. Given multiple barriers to obtaining cardiac PET imaging, we suspect individuals with access to this imaging modality are not representative of the Sarcoid patient population, which in the United States are predominantly Black females.
Objective: To evaluate the demographics of patients with cardiac PET access and the cost-effectiveness of cardiac PET/MR imaging relative to standard of care.
Design: This is a retrospective, observational study. The demographic information of patients with suspected cardiac sarcoidosis and cardiac PET/CT imaging within a national registry of sarcoidosis were reviewed (n = 4561). An individual-level, continuous, time-state transition model was used for the evaluation of long-term cost-effectiveness for the combined cardiac PET/MR compared to standard of care cardiac MR followed by cardiac PET/CT.
Results: Patients who underwent cardiac PET in the national registry had 88.35% higher odds of being male (p < 0.001) and 43.82% higher odds of being White (p = 0.003) than their counterparts who did not have cardiac PET imaging. Combined cardiac PET/MR had overall lower total lifetime costs ($8761 vs $10,777) and overall improved expected quality of life-years compared to the standard of care (0.77 vs 0.69).
Conclusion and Relevance: The findings suggest that patients with access to cardiac PET/CT are not representative of the patient population most likely to have cardiac sarcoidosis in this limited study evaluation. Universal insurance coverage should be considered for Cardiac PET imaging as same day cardiac PET and MR imaging has potential long-term cost and quality of life benefit.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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