Cost-effectiveness and safety of selective use of low-osmolality contrast media.
OBJECTIVE
We estimated our potential institutional savings by switching from universal to selective use of low-osmolality contrast media.


METHODS
A total of 42,598 radiocontrast studies (26,595 with high-osmolality contrast agents and 16,003 with low-osmolality contrast agents [LOCA]) were performed over 42 months. Every radiocontrast reaction was classified and documented. All costs associated with the subsequent treatment of adverse reactions were recorded and added to the cost of contrast agents. The actual cost of contrast agent administration was determined and compared with the theoretical cost of total conversion to LOCA.


RESULTS
The overall rate of adverse reactions was 1.18%. The cost of radiocontrast materials and treatment of adverse reactions was $2,599,593. Over the same period, total conversion to LOCA would have cost $5,968,507.


CONCLUSIONS
Our institution saved an estimated $962,548 annually through the selective use of LOCA. The incremental cost of treating adverse reactions associated with selective use was minimal compared with the cost of total conversion to LOCA.
Michalson
A
A
University of Iowa Hospitals and Clinics, Iowa City 52240, USA.
Franken
E A
EA
Smith
W
W
D003287:Contrast Media / Q000009:adverse effects* / Q000191:economics*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D017721:Hospital Costs; D006801:Humans; D007484:Iowa; D009994:Osmolar Concentration; D011446:Prospective Studies; D012449:Safety
D003287:Contrast Media