Study Finds Economic Benefits for 64-Slice CT, SPECT

A multicenter study has found the cost-savings of the two major noninvasive methods for detecting coronary artery disease (CAD) varies based on the patient's heart history.

The study, performed by researchers from New York Presbyterian/Weill Cornell (New York, NY, USA), revealed that patients who underwent coronary computed tomographic angiography (CCTA), without a prior diagnosis of CAD, incurred costs US$603 lower (per patient average) than those who underwent myocardial perfusion imaging (myocardial perfusion imaging [MPI] or single photon emission tomography [SPECT]). Both groups had equal clinical outcomes. However, patients with known CAD who underwent MPI incurred healthcare costs $2451 lower (per patient average) than costs incurred by CCTA patients with equal clinical outcomes. These results suggest that CCTA may be a cost-efficient alternative in patients without a prior CAD diagnosis.

New York Presbyterian/Weill Cornell Cardiologist Dr. James K. Min presented the study's findings April 2008 at the 57th annual meeting of the American College of Cardiology in Chicago, IL, USA. "These are exciting data,” said Dr. Min. "This provides an initial foundation to suggest that CCTA may be used as a cost-efficient alternative to nuclear stress testing for evaluation of patients with suspected coronary artery disease.”

Recently, the U.S. Centers for Medicare and Medicaid Services (CMS) assigned transaction codes (T-codes) for CT dedicated to coronary angiography. Looking at multicenter payer claims from five health plans with memberships of at least 10 million people, the study examined cost effectiveness for patients undergoing CCT under T-codes, compared to matched patients undergoing MPI testing. Researchers collected data for 142,535 patients who underwent CCT or MPI for nine months before and after the test. Pre-test cardiac risk was assessed by cardiac risk factors and medications. MPI patients were matched to CCT patients using 11 categories of demographic and risk states. Cost and clinical effectiveness were measured in both downstream CAD costs and clinical events including myocardial infarction (MI), angina, and CAD-related hospitalization.


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New York Presbyterian/Weill Cornell