Work

Cost-effectiveness of photon counting detector CT for coronary artery disease diagnostics: A Finnish healthcare perspective

Year: 2025

Type: article

Abstract: PURPOSE: The purpose of this study was to evaluate the cost-effectiveness of photon-counting detector computed tomography (PCD-CT) compared to energy-integrating detector CT (EID-CT) for coronary artery disease (CAD) diagnostics in the Finnish healthcare context. METHODS: Two decision trees, incorporating local cost data and diagnostic pathways, were developed based on previously published Coronary Artery Disease - Reporting and Data System reclassification data for PCD-CT and EID-CT. A bootstrapping Monte Carlo simulation was used to model 10,000 virtual patients across a 10-year scanner lifespan. Two diagnostic scenarios were considered: one based on the diagnostic pathway of a previously published study (scenario 1) and another reflecting local clinical practice (scenario 2). Downstream testing costs and total diagnostic costs of both PCD-CT and EID-CT branches were assessed. The break-even point for PCD-CT investment was determined by including an assumed €1,500,000 price premium over EID-CT. RESULTS: PCD-CT significantly reduced downstream diagnostic testing compared to EID-CT. In scenario 1, mean downstream costs per patient were €377.1 ± 11.5 for PCD-CT and €569.7 ± 11.7 for EID-CT, (33.8 % reduction, p < 0.001). In scenario 2, downstream costs were €831.7 ± 19.7 for PCD-CT and €1138.2 ± 18.3 for EID-CT (26.9 % reduction, p < 0.001). Total diagnostic costs, including CCTA, were also lower with PCD-CT. The cost-benefit threshold was reached after 7,880 and 4,950 patients for scenarios 1 and 2 respectively. CONCLUSIONS: PCD-CT would be a cost-effective alternative to EID-CT in high-volume centers, reducing unnecessary downstream tests through improved diagnostic accuracy. These findings support its adoption in Finnish healthcare systems.

Source: European Journal of Radiology

DOI: 10.1016/j.ejrad.2025.112245

Authors: Mikael A.K. Brix, Marjo Okkonen, Timo Mäkelä, Marko Nikki, Marko Korhonen, Miika T. Nieminen

Institutions: Oulu University Hospital, University of Oulu

Language: English

Topic: Cardiac Imaging and Diagnostics

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,440