Activity-based costing evaluation of [18F]-fludeoxyglucose production.
BACKGROUND
As healthcare expenses are escalating in many countries, the sector faces a new challenge of becoming more cost efficient. There is an urgent need for more accurate data on the costs of healthcare procedures. The cost of Positron Emission Tomography (PET) with [(18)F]-fludeoxyglucose ((18)F-FDG) studies is mainly influenced by the price of the radiopharmaceutical, which may vary throughout Europe from 300 to 500 Euro per patient dose (370 MBq). The aim of the current study is to conduct an activity-based costing (ABC) estimation of (18)F-FDG production in Europe to better identify the different cost components and to analyse their relative contribution to the total cost.


METHODS
Financial data were collected on capital expense and global operating costs through interviews with industry experts, PET centre managers, evaluation of prior studies, and review of expenses incurred at the University Medical Centre in Groningen (The Netherlands). After mapping the activities, we divided the cost in five categories: wage, equipment, consumables, overhead and space costs. A sensitivity analysis was performed for key cost components, including the compliance with regulatory requirements.


RESULTS
The critical factor for profitability was throughput. Including the European regulation procedure, the cost for 370 MBq (18)F-FDG patient dose, 3 h EOS without delivery cost, ranges between 155 and 177 Euro/dose for two production runs and between 210 and 237 Euro/dose for one production run. These costs are predominantly determined by personnel and equipment costs, although the cost for quality assurance increases steadily.


CONCLUSIONS
The ABC analysis provides significant insight into the production cost components of (18)F-FDG through different operating configurations. Reductions in equipment prices, increased availability of radiopharmaceuticals, growth in demand, and improvements in reimbursement will all contribute to the financial viability of this imaging technique.
Krug
Bruno
B
Nuclear Medicine Division, Université Catholique de Louvain, Mont-Godinne Medical Centre, 1 Dr Therasse, 5530, Yvoir, Belgium. bruno.krug@mnuc.ucl.ac.be
Van Zanten
Annie
A
Pirson
Anne-Sophie
AS
Crott
Ralph
R
Vander Borght
Thierry
T
D003365:Costs and Cost Analysis / Q000379:methods*; D019788:Fluorodeoxyglucose F18 / Q000191:economics*; D006801:Humans; D049268:Positron-Emission Tomography / Q000191:economics; D011829:Radiation Dosage; D012680:Sensitivity and Specificity; D012926:Social Control, Formal; D013997:Time Factors
D019788:Fluorodeoxyglucose F18