Capsule endoscopy in suspected small bowel Crohn's disease: economic impact of disease diagnosis and treatment.
OBJECTIVE
To model clinical and economic benefits of capsule endoscopy (CE) compared to ileo-colonoscopy and small bowel follow-through (SBFT) for evaluation of suspected Crohn's disease (CD).


METHODS
Using decision analytic modeling, total and yearly costs of diagnostic work-up for suspected CD were calculated, including procedure-related adverse events, hospitalizations, office visits, and medications. The model compared CE to SBFT following ileo-colonoscopy and secondarily compared CE to SBFT for initial evaluation.


RESULTS
Aggregate charges for newly diagnosed, medically managed patients are approximately $8295. Patients requiring aggressive medical management costs are $29,508; requiring hospitalization, $49,074. At sensitivity > 98.7% and specificity of > 86.4%, CE is less costly than SBFT.


CONCLUSIONS
Costs of CE for diagnostic evaluation of suspected CD is comparable to SBFT and may be used immediately following ileo-colonoscopy.
Leighton
Jonathan A
JA
Division of Health Policy, Department of Radiology, University of California San Diego, San Diego, CA 92103, USA.
Gralnek
Ian M
IM
Richner
Randel E
RE
Lacey
Michael J
MJ
Papatheofanis
Frank J
FJ
D053704:Capsule Endoscopy / Q000191:economics* / Q000379:methods; D002986:Clinical Trials as Topic; D003424:Crohn Disease / Q000175:diagnosis* / Q000191:economics / Q000473:pathology / Q000628:therapy; D016208:Databases, Factual; D003657:Decision Making; D017048:Health Care Costs; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007421:Intestine, Small / Q000473:pathology; D018803:Models, Economic; D009010:Monte Carlo Method; D012680:Sensitivity and Specificity