Cardiovascular imaging optimal diagnostic strategy for stable CHD
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Cardiovascular imaging optimal diagnostic strategy for stable CHD Cardiovascular magnetic resonance (CMR) is a cost-effective initial investigation strategy for patients with stable coronary heart disease (CHD), according to a study from the UK. The study used data from the CE-MARC 2* trial to assess the cost effectiveness, from a UK NHS perspective, of three diagnostic strategies in patients with suspected CHD considered suitable for coronary revascularisation: CMR; myocardial perfusion scintigraphy (MPS); or a risk-stratified approach based on the UK NICE guidelines. CMR was the most effective and least costly strategy overall, with a higher number of mean QALYs per patient, compared with MPS and NICE guidelines (2.20568 vs 2.11400 and 2.06854, respectively) and lower mean cost per patient (£1624.82 vs £1767.87 and £1753.24, respectively). The mean incremental net health benefit per patient of CMR, compared with NICE guidelines, ranged from 0.141 to 0.146 QALYs for the health opportunity cost estimates of £30 000 to £15 000 per QALY, respectively. CMR was also the most effective and cost-effective strategy for all subgroups stratified according to low, medium and high pre-test likelihood. The results were robust across alternative scenarios. However, the researchers note that the differences in costs and outcomes were "highly uncertain" and the findings "need to be interpreted with caution." Nevertheless, the researchers conclude "the current findings suggest that CMR directed care is cost-effective and has a high prognostic value relative to MPS and NICE guidelines directed care." Walker S, et al. Cardiovascular imaging optimal diagnostic strategy for stable CHD Heart : 1 Sep 2020. Available from: URL: https://heart.bmj.com/content/ early/2020/08/19/heartjnl-2020-316990.info
1173-5503/20/0861-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
803500425
PharmacoEconomics & Outcomes News 5 Sep 2020 No. 861
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