Cost-effectiveness of MR angiography in cases of limb-threatening peripheral vascular disease.
OBJECTIVE
To evaluate the cost-effectiveness of magnetic resonance (MR) angiography in the preoperative planning of treatment in patients with limb-threatening peripheral vascular disease (PVD).


METHODS
A decision model was developed to study the effects of MR angiography on the outcome and cost of treatment. The authors calculated the incremental cost per quality-adjusted life-years gained (ie, cost-effectiveness ratio) when conventional angiography was replaced or supplemented with MR angiography. Previously reported data regarding the accuracies of MR and conventional angiography were used in the analysis.


RESULTS
The cost-effectiveness ratio of MR angiography ranged from negative (cost-reducing) values to $78,000. For the base case in which the sensitivity and specificity of MR angiography for the evaluation of inflow vessels were 92% and 88% and those of conventional angiography were 97% and 97%, respectively, the cost-effectiveness ratio was $25,895.


CONCLUSIONS
MR angiography may be a cost-effective alternative to conventional angiography in patients with limb-threatening PVD if its accuracy for the inflow evaluation reaches certain thresholds. Further prospective investigation is warranted.
Yin
D
D
Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia 19104.
Baum
R A
RA
Carpenter
J P
JP
Langlotz
C P
CP
Pentecost
M J
MJ
D000792:Angiography / Q000191:economics; D001807:Blood Vessel Prosthesis; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003661:Decision Support Techniques; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000191:economics*; D017063:Outcome Assessment, Health Care; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000191:economics* / Q000601:surgery; D011300:Preoperative Care; D011788:Quality of Life; D012680:Sensitivity and Specificity; D016896:Treatment Outcome