Evaluating the cost-effectiveness of [18F]FDG-PET/CT for investigation of persistent or recurrent neutropenic fever in high-risk haematology patients
© 2023. The Author(s)..
BACKGROUND: A recent randomised trial demonstrated [18F]fluorodeoxyglucose positron-emission tomography in combination with low-dose CT (FDG-PET/CT), compared to standard of care computed tomography (CT) imaging, positively impacted antimicrobial management and outcomes of acute leukaemia and haematopoietic stem cell transplant recipients with persistent and recurrent neutropenic fever. We conducted an economic evaluation from a healthcare perspective alongside the clinical trial.
METHODS: Unit costs in Australian dollars were applied to all resources used (antimicrobials, diagnostic tests, ICU and hospital bed days). Effectiveness was measured as number of patients with antimicrobial rationalisation, 6-month mortality and quality-adjusted life years (QALYs) derived from patient-reported trial-based health-related quality-of-life. Generalised linear models were used to analyse costs and outcomes. Incremental cost-effectiveness ratios (ICERs) for all outcomes and net monetary benefit (NMB) for QALYs were calculated. We performed bootstrapping with 1000 replications using the recycled predictions method.
RESULTS: The adjusted healthcare costs were lower for FDG-PET/CT (mean $49,563; 95%CI 36,867, 65,133) compared to CT (mean $57,574; 95% CI 44,837, 73,347). The difference in QALYs between the two groups was small (0.001; 95% CI -0.001, 0.004). When simulated 1000 times, FDG-PET/CT was the dominant strategy as it was cheaper with better outcomes than the standard CT group in 74% of simulations. The estimated NMBs at willingness-to-pay thresholds of $50,000 and $100,000 per QALY were positive, thus FDG-PET/CT remained cost-effective at these thresholds.
CONCLUSIONS: FDG-PET/CT is cost effective when compared to CT for investigation of persistent/recurrent neutropenic fever in high-risk patients, providing further support for incorporation of FDG-PET/CT into clinical guidelines and funding.
TRIAL REGISTRATION: This trial is registered with ClinicalTrials.gov, NCT03429387.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:23 |
|---|---|
| Enthalten in: |
Cancer imaging : the official publication of the International Cancer Imaging Society - 23(2023), 1 vom: 15. Dez., Seite 119 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Tew, Michelle [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
0Z5B2CJX4D |
|---|
| Anmerkungen: |
Date Completed 10.01.2024 Date Revised 10.01.2024 published: Electronic ClinicalTrials.gov: NCT03429387 Citation Status MEDLINE |
|---|
| doi: |
10.1186/s40644-023-00647-7 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM365933325 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM365933325 | ||
| 003 | DE-627 | ||
| 005 | 20240114233846.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231227s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1186/s40644-023-00647-7 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1256.xml |
| 035 | |a (DE-627)NLM365933325 | ||
| 035 | |a (NLM)38102639 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Tew, Michelle |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Evaluating the cost-effectiveness of [18F]FDG-PET/CT for investigation of persistent or recurrent neutropenic fever in high-risk haematology patients |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 10.01.2024 | ||
| 500 | |a Date Revised 10.01.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT03429387 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a BACKGROUND: A recent randomised trial demonstrated [18F]fluorodeoxyglucose positron-emission tomography in combination with low-dose CT (FDG-PET/CT), compared to standard of care computed tomography (CT) imaging, positively impacted antimicrobial management and outcomes of acute leukaemia and haematopoietic stem cell transplant recipients with persistent and recurrent neutropenic fever. We conducted an economic evaluation from a healthcare perspective alongside the clinical trial | ||
| 520 | |a METHODS: Unit costs in Australian dollars were applied to all resources used (antimicrobials, diagnostic tests, ICU and hospital bed days). Effectiveness was measured as number of patients with antimicrobial rationalisation, 6-month mortality and quality-adjusted life years (QALYs) derived from patient-reported trial-based health-related quality-of-life. Generalised linear models were used to analyse costs and outcomes. Incremental cost-effectiveness ratios (ICERs) for all outcomes and net monetary benefit (NMB) for QALYs were calculated. We performed bootstrapping with 1000 replications using the recycled predictions method | ||
| 520 | |a RESULTS: The adjusted healthcare costs were lower for FDG-PET/CT (mean $49,563; 95%CI 36,867, 65,133) compared to CT (mean $57,574; 95% CI 44,837, 73,347). The difference in QALYs between the two groups was small (0.001; 95% CI -0.001, 0.004). When simulated 1000 times, FDG-PET/CT was the dominant strategy as it was cheaper with better outcomes than the standard CT group in 74% of simulations. The estimated NMBs at willingness-to-pay thresholds of $50,000 and $100,000 per QALY were positive, thus FDG-PET/CT remained cost-effective at these thresholds | ||
| 520 | |a CONCLUSIONS: FDG-PET/CT is cost effective when compared to CT for investigation of persistent/recurrent neutropenic fever in high-risk patients, providing further support for incorporation of FDG-PET/CT into clinical guidelines and funding | ||
| 520 | |a TRIAL REGISTRATION: This trial is registered with ClinicalTrials.gov, NCT03429387 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antimicrobial | |
| 650 | 4 | |a Cost-effectiveness | |
| 650 | 4 | |a Costing | |
| 650 | 4 | |a Diagnostic imaging | |
| 650 | 4 | |a Febrile neutropenia | |
| 650 | 7 | |a Anti-Infective Agents |2 NLM | |
| 650 | 7 | |a Fluorodeoxyglucose F18 |2 NLM | |
| 650 | 7 | |a 0Z5B2CJX4D |2 NLM | |
| 700 | 1 | |a Douglas, Abby P |e verfasserin |4 aut | |
| 700 | 1 | |a Szer, Jeff |e verfasserin |4 aut | |
| 700 | 1 | |a Bajel, Ashish |e verfasserin |4 aut | |
| 700 | 1 | |a Harrison, Simon J |e verfasserin |4 aut | |
| 700 | 1 | |a Tio, Shio Yen |e verfasserin |4 aut | |
| 700 | 1 | |a Worth, Leon J |e verfasserin |4 aut | |
| 700 | 1 | |a Hicks, Rodney J |e verfasserin |4 aut | |
| 700 | 1 | |a Ritchie, David |e verfasserin |4 aut | |
| 700 | 1 | |a Slavin, Monica A |e verfasserin |4 aut | |
| 700 | 1 | |a Thursky, Karin A |e verfasserin |4 aut | |
| 700 | 1 | |a Dalziel, Kim |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Cancer imaging : the official publication of the International Cancer Imaging Society |d 2000 |g 23(2023), 1 vom: 15. Dez., Seite 119 |w (DE-627)NLM15769819X |x 1470-7330 |7 nnns |
| 773 | 1 | 8 | |g volume:23 |g year:2023 |g number:1 |g day:15 |g month:12 |g pages:119 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1186/s40644-023-00647-7 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 23 |j 2023 |e 1 |b 15 |c 12 |h 119 | ||