A United States Payer Budget Impact Analysis of Myocardial Perfusion Imaging Modalities Positron Emission Tomography with Flurpiridaz Compared to Single Photon Emission Computed Tomography in Coronary Artery Disease Diagnosis


Priest S1, Walczyk Mooradally A1, Ferko N1, Szabo E2, Cabra HA3
1EVERSANA, Burlington, ON, Canada, 2GE HealthCare, Pittsburgh, PA, USA, 3GE HealthCare, Miami, FL, USA

OBJECTIVES: Coronary artery disease (CAD) is a growing health problem in the United States (U.S.) and presents significant clinical and economic burden to patients and healthcare systems. Nuclear-based myocardial perfusion imaging (MPI) modalities, single-photon emission computed tomography (SPECT) and positron emission tomography (PET) are clinically indicated for CAD diagnosis in individuals with an intermediate pre-test probability for CAD. While SPECT has diagnostic challenges, PET has emerged as a compelling alternative due to enhanced image quality and refined attenuation correction. This study assessed the affordability of PET with a novel radiotracer compared to SPECT for CAD diagnosis from a U.S. payer perspective.

METHODS: A budget impact model was developed with a 5-year time horizon. Four suspected CAD analysis populations (general, women, body mass index [BMI] >30kg/m2, and diabetes) were selected based on appropriate use criteria guidelines and difficulty in realizing a SPECT efficiently. In brief, the model linked diagnostic performance to downstream outcomes (i.e., healthcare resource utilization [HCRU] and cardiac events) and used coverage payment codes to quantify MPI modality costs. The budget impact was measured through a comparison of two hypothetical scenarios: 1) a world without PET with a novel radiotracer and 2) a world with PET with a novel radiotracer. Results are reported as incremental per member per month (PMPM) costs.

RESULTS: The 5-year average PMPM net budget impact is -$0.21, -$0.10, -$0.11, and -$0.14, for general, women, BMI>30kg/m2, and diabetes populations, respectively, indicating cost-savings in the world with PET with a novel radiotracer. Annual cost-savings were also observed in all populations. Savings resulted from reductions in HCRU (e.g., revascularization procedures).

CONCLUSIONS: This comprehensive analysis illustrates that the adoption of PET with a novel radiotracer with increased diagnostic performance demonstrates economic benefits compared to SPECT for CAD diagnosis. These findings can be used to inform U.S. healthcare decision makers.

Conference/Value in Health Info

2024-05, ISPOR 2024, Atlanta, GA, USA

Value in Health, Volume 27, Issue 6, S1 (June 2024)




Economic Evaluation, Medical Technologies

Topic Subcategory

Budget Impact Analysis, Diagnostics & Imaging


Cardiovascular Disorders (including MI, Stroke, Circulatory), Medical Devices

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