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KMID : 1146320210090020108
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Journal of Health Technology Assessment
2021 Volume.9 No. 2 p.108 ~ p.114
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Cost-Minimization Analysis of Nuclear Scintigraphy for Transthyretin Amyloid Cardiomyopathy Diagnosis Compared With Endomyocardial Biopsy in Korea
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Park Sun-Kyeong
Lee Ju-Eun
Kim Hye-Lin
Choi You-Jung
Paeng Jin-Chul
Lee Seung-Pyo
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Abstract
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Objectives: To conduct a cost-minimization analysis (CMA) of nuclear scintigraphy (NS) compared to endomyocardial biopsy (EMB) for transthyretin amyloid cardiomyopathy (ATTR-CM) diagnosis in Korea.
Methods: CMA was performed using a decision tree model. The target populations were patients with suspected ATTR-CM. After screening of the entire target populations to rule out amyloid light-chain amyloidosis, patients were assigned to either NS followed by EMB as needed (NS group) or EMB without an NS as a gatekeeper (EMB group). We assumed that 12% of the NS group would not meet the diagnostic criteria of ATTR-CM and that these patients would still receive EMB after the NS. We calculated the costs from the healthcare system perspective using the micro-costing approach. One-way sensitivity analysis was conducted.
Results: The overall cost was estimated at 717,714 KRW per patient in the NS group and 1,425,772 KRW per patient in the EMB group. Consequently, the NS group cost 708,058 KRW less than the EMB group. The sensitivity analysis result showed that the higher the proportion of patients undergoing EMB after the NS, the lower the cost reduction effect.
Conclusion: Compared to direct EMB for ATTR-CM diagnosis, selective EMB after NS reduces the overall costs in Korea.
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KEYWORD
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Radionuclide imaging, Biopsy, Diagnosis, Costs and cost analysis
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