Berger Magdalena, Gould Michael K, Barnett Paul G
VA Palo Alto Health Care System, VA Cooperative Studies Program Coordinating Center, VA HSR&D Health Economics Resource Center, Menlo Park, CA 94025, USA.
AJR Am J Roentgenol. 2003 Aug;181(2):359-65. doi: 10.2214/ajr.181.2.1810359.
Positron emission tomography (PET) is a high-cost imaging tool primarily used in oncology, cardiology, and neuropsychiatry. Accurate estimates of the cost of PET are needed to assess its cost effectiveness and determine the appropriate role for this modality in clinical applications. We performed a survey-based cost analysis of PET with FDG by estimating direct, indirect, and capital costs from eight PET centers. A breakdown of the operational budget of PET centers and FDG-compounding facilities is presented along with the costs per scan. Differences in costs between sites that purchase FDG and those that manufacture FDG are also examined.
We sent surveys to managers of eight Veterans Affairs and two non-Veterans Affairs PET scanning and FDG-compounding facilities. The survey included questions about service volume and the direct costs of equipment, personnel, space, supplies, and repairs needed for FDG compounding and PET scanning and interpretation. We estimated the indirect costs associated with FDG compounding, PET scanning, and PET interpretation.
Of the eight sites that responded to our survey, three sites manufacture FDG on-site, three sites purchase FDG, and two sites do both. The total mean cost per scan using manufactured FDG is 1885 US dollars, and it is 1898 US dollars using purchased FDG.
PET is expensive. The cost is similar when FDG is manufactured or purchased. Because both PET and cyclotron facilities have high fixed costs, increasing the number of scans obtained and the number of FDG doses manufactured may lead to a decrease in unit costs.
正电子发射断层扫描(PET)是一种高成本的成像工具,主要用于肿瘤学、心脏病学和神经精神病学领域。需要准确估计PET的成本,以评估其成本效益,并确定该模式在临床应用中的适当作用。我们通过估计八个PET中心的直接、间接和资本成本,对使用氟代脱氧葡萄糖(FDG)的PET进行了基于调查的成本分析。本文介绍了PET中心和FDG合成设施的运营预算细目以及每次扫描的成本。还研究了购买FDG的场所和生产FDG的场所之间的成本差异。
我们向八个退伍军人事务部以及两个非退伍军人事务部的PET扫描和FDG合成设施的管理人员发送了调查问卷。该调查包括有关服务量以及FDG合成、PET扫描和解读所需的设备、人员、空间、用品和维修的直接成本的问题。我们估计了与FDG合成、PET扫描和PET解读相关的间接成本。
在回复我们调查的八个场所中,三个场所现场生产FDG,三个场所购买FDG,两个场所既生产又购买。使用生产的FDG时每次扫描的总平均成本为1885美元,使用购买的FDG时为1898美元。
PET成本高昂。生产或购买FDG时成本相似。由于PET和回旋加速器设施都有很高的固定成本,增加扫描次数和FDG剂量的生产数量可能会导致单位成本下降。