RT Journal Article
SR Electronic
T1 Nonionic contrast media: economic analysis and health policy development
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 389
OP 395
VO 140
IS 4
A1 V. Goel
A1 R. B. Deber
A1 A. S. Detsky
YR 1989
UL http://www.cmaj.ca/content/140/4/389.abstract
AB The replacement of old radiologic contrast media with supposedly safer but more expensive media has created a dilemma for radiologists and hospital administrators. To quantitate the nature of this trade-off we performed a cost-utility analysis using optimistic assumptions that favoured the new media. A complete conversion to the new media would result in an incremental cost of at least $65,000 to gain 1 quality-adjusted life-year (QALY). For a selective strategy in which only high-risk patients would receive the new media the cost would be about $23,000 per QALY gained. However, the incremental cost for low-risk patients is over $220,000 per QALY gained. Conversion to the new contrast media, although not necessarily the most efficient use of scarce resources, has already occurred in Ontario, primarily because of press publicity, pressure from insurers and a political unwillingness of policymakers to decide the fate of identifiable victims. We found that funding of a new intervention associated with a high cost-utility ratio rather than interventions with lower ratios might save some identifiable victims at the expense of a larger number of unidentifiable ones.