학술논문
COST-BENEFIT ANALYSIS OF THE INTRODUCTION OF MP-MRI GUIDED BIOPSIES IN CROATIA/ANALIZA ISPLATIVOSTI UVODENJA BIOPSIJE PROSTATE NAVODENE MULTIPARAMETRIJSKOM MAGNETSKOM REZONANCOM
Original Scientific Paper
Original Scientific Paper
Document Type
Clinical report
Author
Source
Acta Clinica Croatica. March 15, 2018, Vol. 57 Issue S1, p49, 4 p.
Subject
Language
English
ISSN
0353-9466
Abstract
IntroductionOver the last couple of decades, health system funding has become a major topic in the world. We are witnessing a constant increase of the cost of medical services around [...]
Continuous increase of the cost of medical services around the world has become a major topic in the world today. Multiparametric prostate MRI has recently become a new standard in prostate cancer detection, especially in repeated biopsy settings. The method, although superior in cancer detection rates, is costly and requires additional training and equipment. The purpose of our study was to determine the costs and benefits that arise when introducing this method in prostate cancer diagnostics. Repeated prostate biopsy was performed in 101 consecutive patients in the period from 1 October 2016 to 1 July 2017. Patients were divided into two groups based on whether prostate mp-MRI was performed or not. The prices of specific procedures were obtained from the billing service of the Sestre milosrdnice University Hospital Center and patient models were created to determine financial costs and benefits. The cost of the entire diagnostic process per patient in the non-MRI group was HRK 1.931,05 and HRK 1.848,42 in the mpMRI group, or 4.28% less. Prostate mpMRI and subsequent mpMRI guided biopsies can reduce the overall cost in prostate cancer diagnostics despite the procedure itself being an additional cost. This is achieved by omitting prostate biopsies in patients with low malignancy risk.Key words: Prostate mp-MRI; Prostate cancer, cost benefitKontinuirani rast troskova medicinskih postupaka aktualna je tema i razlog zabrinutosti u cijelome svijetu. Ciljana, multiparametrijskim magnetom (mpMRI) navodena biopsija prostate polako postaje standard u dijagnostici karcinoma prostate, pogotovo kod ponovljene biopsije. Iako superiorna klasicnoj, sistemskoj biopsiji prostate, navedena metoda zahtijeva skupu dodatnu opremu i vjeste, educirane klinicare. Nas cilj je analizirati ekonomsku isplativost uvodenja multiparametrijske magnetne rezonance prostate i posljedicne kognitivno mpMRI-om navodene biopsije prostate u dijagnosticki protokol bolesnika sa inicijalno negativnom sistemskom biopsijom prostate, kod kojih postoji daljnja klinicka sumnja na karcinom prostate. U periodu od 01.10.2016. do 01.07.2017 kod 101 uzastopnog bolesnika s povisenim PSA i/ili pozitivnim DRP, a nakon negativne prve TRUS biopsije ucinjena je druga, ponovljena biopsija prostate. Bolesnici su podijeljeni u dvije skupine ovisno o tome dali je ucinjen mpMRI prostate ili ne. Ucinjena je analiza broja i troskova posjeta specijalisti urologu kao i broja i troskova ordiniranih pretraga za svaku skupinu. Tijek klinickih postupaka standardiziran je na temelju prosjeka za pojedine promatrane skupine te preracunat na 100 bolesnika za svaku skupinu radi lakse usporedbe rezultata. Kalkulacije su vrsene na temelju dobivenih modela. Prosjecna cijena obrade bolesnika u skupini bez mpMRI-a iznosi 1931,05 HRK dok u sa mpMRI-em iznosi 1848,42 HRK tj. 4,28% manje. Iako mpMRI prostate pojedinacno predstavlja znacajan dodatan trosak u dijagnostici karcinoma prostate, kod bolesnika sa inicijalno negativnom biopsijom prostate isti omogucava velikom broju bolesnika izbjegavanje biopsije te posljedicno smanjenje ukupnog troska.Kljucne rijeci: Karcinomprostate; Navodena biopsija, isplativost; Multiparametrijska magnetska rezonanca
Continuous increase of the cost of medical services around the world has become a major topic in the world today. Multiparametric prostate MRI has recently become a new standard in prostate cancer detection, especially in repeated biopsy settings. The method, although superior in cancer detection rates, is costly and requires additional training and equipment. The purpose of our study was to determine the costs and benefits that arise when introducing this method in prostate cancer diagnostics. Repeated prostate biopsy was performed in 101 consecutive patients in the period from 1 October 2016 to 1 July 2017. Patients were divided into two groups based on whether prostate mp-MRI was performed or not. The prices of specific procedures were obtained from the billing service of the Sestre milosrdnice University Hospital Center and patient models were created to determine financial costs and benefits. The cost of the entire diagnostic process per patient in the non-MRI group was HRK 1.931,05 and HRK 1.848,42 in the mpMRI group, or 4.28% less. Prostate mpMRI and subsequent mpMRI guided biopsies can reduce the overall cost in prostate cancer diagnostics despite the procedure itself being an additional cost. This is achieved by omitting prostate biopsies in patients with low malignancy risk.Key words: Prostate mp-MRI; Prostate cancer, cost benefitKontinuirani rast troskova medicinskih postupaka aktualna je tema i razlog zabrinutosti u cijelome svijetu. Ciljana, multiparametrijskim magnetom (mpMRI) navodena biopsija prostate polako postaje standard u dijagnostici karcinoma prostate, pogotovo kod ponovljene biopsije. Iako superiorna klasicnoj, sistemskoj biopsiji prostate, navedena metoda zahtijeva skupu dodatnu opremu i vjeste, educirane klinicare. Nas cilj je analizirati ekonomsku isplativost uvodenja multiparametrijske magnetne rezonance prostate i posljedicne kognitivno mpMRI-om navodene biopsije prostate u dijagnosticki protokol bolesnika sa inicijalno negativnom sistemskom biopsijom prostate, kod kojih postoji daljnja klinicka sumnja na karcinom prostate. U periodu od 01.10.2016. do 01.07.2017 kod 101 uzastopnog bolesnika s povisenim PSA i/ili pozitivnim DRP, a nakon negativne prve TRUS biopsije ucinjena je druga, ponovljena biopsija prostate. Bolesnici su podijeljeni u dvije skupine ovisno o tome dali je ucinjen mpMRI prostate ili ne. Ucinjena je analiza broja i troskova posjeta specijalisti urologu kao i broja i troskova ordiniranih pretraga za svaku skupinu. Tijek klinickih postupaka standardiziran je na temelju prosjeka za pojedine promatrane skupine te preracunat na 100 bolesnika za svaku skupinu radi lakse usporedbe rezultata. Kalkulacije su vrsene na temelju dobivenih modela. Prosjecna cijena obrade bolesnika u skupini bez mpMRI-a iznosi 1931,05 HRK dok u sa mpMRI-em iznosi 1848,42 HRK tj. 4,28% manje. Iako mpMRI prostate pojedinacno predstavlja znacajan dodatan trosak u dijagnostici karcinoma prostate, kod bolesnika sa inicijalno negativnom biopsijom prostate isti omogucava velikom broju bolesnika izbjegavanje biopsije te posljedicno smanjenje ukupnog troska.Kljucne rijeci: Karcinomprostate; Navodena biopsija, isplativost; Multiparametrijska magnetska rezonanca