Cost‐effectiveness of 123I‐FP‐CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy
Identifieur interne : 000E33 ( Main/Exploration ); précédent : 000E32; suivant : 000E34Cost‐effectiveness of 123I‐FP‐CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy
Auteurs : Angelo Antonini [Italie] ; Patrizia Berto [Italie] ; Stefania Lopatriello [Italie] ; Filippo Tamma [Italie] ; Lieven Annemans [Belgique] ; Mike Chambers [Royaume-Uni]Source :
- Movement Disorders [ 0885-3185 ] ; 2008-11-15.
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Abstract
Economic evaluation (Italian NHS perspective) modeling 123I‐FP‐CIT SPECT (DaTSCAN®) compared to clinical judgment alone for differentiating essential tremor (ET) from Parkinson's Disease (PD). A 5‐year Markov model was constructed to assess the cost‐effectiveness of 123I‐FP‐CIT SPECT to differentiate ET from PD in patients referred to a movement disorder specialist in Italy. Published data and a double‐round, Delphi panel of 12 specialists populated the model. Effectiveness was expressed as the projected Years on potentially beneficial therapy (PBTYs). Costs were expressed in Euros (2005 values). The model suggests that over 5 years, the “current” diagnostic pathway generated an average of 2.3 PBTYs/patient at an estimated cost of €8,864. 123I‐FP‐CIT SPECT generated an average of 4.1 PBTYs/patient at an estimated cost of €8,422, which represented an additional 1.8 PBTYs at a cost saving of €442/patient (€341 when discounted at 5%). The estimated cost‐effectiveness of 123I‐FP‐CIT SPECT is under €1,000 per PBTY gained when the underlying disease prevalence is high (55–70%), and cost‐saving at prevalence under 55%. 123I‐FP‐CIT SPECT is likely to be regarded as economically advantageous to differentiate ET from PD, increasing time on potentially beneficial therapy at a lower overall cost to the healthcare system. © 2008 Movement Disorder Society
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DOI: 10.1002/mds.22278
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2008-11-15">2008-11-15</date><biblScope unit="volume">23</biblScope><biblScope unit="issue">15</biblScope><biblScope unit="page" from="2202">2202</biblScope><biblScope unit="page" to="2209">2209</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">C9F93480604AF95B462D61550F1DC0EDBF1BA469</idno><idno type="DOI">10.1002/mds.22278</idno><idno type="ArticleID">MDS22278</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>123I‐FP‐CIT</term><term>DaTSCAN®</term><term>Parkinson's disease</term><term>Parkinsonism</term><term>cost‐effectiveness</term><term>essential tremor</term><term>single photon emission computed tomography (SPECT)</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="fr">Economic evaluation (Italian NHS perspective) modeling 123I‐FP‐CIT SPECT (DaTSCAN®) compared to clinical judgment alone for differentiating essential tremor (ET) from Parkinson's Disease (PD). A 5‐year Markov model was constructed to assess the cost‐effectiveness of 123I‐FP‐CIT SPECT to differentiate ET from PD in patients referred to a movement disorder specialist in Italy. Published data and a double‐round, Delphi panel of 12 specialists populated the model. Effectiveness was expressed as the projected Years on potentially beneficial therapy (PBTYs). Costs were expressed in Euros (2005 values). The model suggests that over 5 years, the “current” diagnostic pathway generated an average of 2.3 PBTYs/patient at an estimated cost of €8,864. 123I‐FP‐CIT SPECT generated an average of 4.1 PBTYs/patient at an estimated cost of €8,422, which represented an additional 1.8 PBTYs at a cost saving of €442/patient (€341 when discounted at 5%). The estimated cost‐effectiveness of 123I‐FP‐CIT SPECT is under €1,000 per PBTY gained when the underlying disease prevalence is high (55–70%), and cost‐saving at prevalence under 55%. 123I‐FP‐CIT SPECT is likely to be regarded as economically advantageous to differentiate ET from PD, increasing time on potentially beneficial therapy at a lower overall cost to the healthcare system. © 2008 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Belgique</li><li>Italie</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Lombardie</li></region><settlement><li>Milan</li></settlement></list><tree><country name="Italie"><region name="Lombardie"><name sortKey="Antonini, Angelo" sort="Antonini, Angelo" uniqKey="Antonini A" first="Angelo" last="Antonini">Angelo Antonini</name></region><name sortKey="Berto, Patrizia" sort="Berto, Patrizia" uniqKey="Berto P" first="Patrizia" last="Berto">Patrizia Berto</name><name sortKey="Lopatriello, Stefania" sort="Lopatriello, Stefania" uniqKey="Lopatriello S" first="Stefania" last="Lopatriello">Stefania Lopatriello</name><name sortKey="Tamma, Filippo" sort="Tamma, Filippo" uniqKey="Tamma F" first="Filippo" last="Tamma">Filippo Tamma</name></country><country name="Belgique"><noRegion><name sortKey="Annemans, Lieven" sort="Annemans, Lieven" uniqKey="Annemans L" first="Lieven" last="Annemans">Lieven Annemans</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Chambers, Mike" sort="Chambers, Mike" uniqKey="Chambers M" first="Mike" last="Chambers">Mike Chambers</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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