Caetano, R., Biz, A.N., Schluckebier, L.F. et al. (3 more authors) (2016) Custo-efetividade do uso da tomografia de emissão de pósitrons na detecção de recorrência do câncer diferenciado de tireoide/Cost-effectiveness of the use of positron emission tomography in the detection of recurrence of differentiated thyroid cancer. Physis: Revista de Saúde Coletiva, 26 (1). pp. 331-356. ISSN 0103-7331
Abstract
The positron emission tomography (18FDG-PET/CT) was recently introduced in Brazilian health care for many oncology indications but accompanied by higher costs. In our study we performed a cost-effectiveness analysis of the addition of PET/CT to the conventional diagnostic work-up to detect recurrent differentiated thyroid cancers. The analytical decision model represented a hypothetical cohort of adults, thyroid cancer patients with high risk by initial stratification, submitted to total thyroidectomy and ablation with I131. The addition of PET/CT was applied to subjects with negative results on I131scintigraphy. The model was designed from the perspective of the Brazilian public health care system, with a time horizon of 10 years. Effectiveness was measured by the additional recurrent cases detected. Only direct medical costs were considered. Costs and benefits were discounted by 5%. Univariate deterministic and probabilistic sensitivity analyzes were performed to explore the uncertainties. The PET/CT diagnosed 13 additional cases compared to conventional strategy (1,888 vs 1,875) by a cost of R$477,633.05 per case detected. The parameters of greatest impact in the sensitivity analysis were the accuracy of conventional tests, cost of PET/CT and the discount rate. The costs of adding PET/CT seems significant and its introduction is not cost-effective on the Brazilian perspective.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2016 Physis: Revista de Saúde Coletiva. |
Keywords: | thyroid cancer; differentiated thyroid carcinoma; cost-effectiveness analysis; 18F-FDG-PET; positron emission tomography |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 04 Apr 2019 14:34 |
Last Modified: | 04 Apr 2019 14:34 |
Status: | Published |
Publisher: | Universidade do Estado do Rio de Janeiro |
Refereed: | Yes |
Identification Number: | 10.1590/s0103-73312016000100018 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:143402 |