Economic Evaluation of Positron Emission Tomography (PET) in Non Small Cell Lung Cancer (NSCLC), CHERE Working Paper 2007/6



Scott 1998, USA

a) CT - if positive then
mediastinoscopy

b) PET after negative CT
(mediastinoscopy after +ve

PET or +ve CT )

c) PET and CT
(mediastinoscopy after +ve
PET)

d) PET and CT
(mediastinoscopy after +ve
CT or +ve PET or -ve CT)

Potentially
operable
NSCLC

Cost
effectiveness

LY gained

Decision
Analysis

b) vs a) 0.007
LY

c) vs a) 0.009
LY

d) vs a) 0.007
LY

b) vs a) $177
c) vs a) $638
d) vs a) $965

b) vs a) $25,286/
LY gained

c) vs a) $70,889/
LY gained

d) vs a) $37,857/
LY gained

Verboom et al
(2003)
The Netherlands

a) Conventional work up
(CWU) Including CT,
MRI, ultrasound, bone
scan, invasive test
brochoscopym
mediastinoscopy and
invasive surgery.

b) CWU + 18 FDG- PET
(whole body)_____________

Medically
operable
NSCLC
(n188)

Cost
effectiveness

Number of futile
thoractomies

Randomised
Control trial

a) 39 futile
thoractomies

b) 19 futile
thoractomies

a) € 9,573

b) € 8284

CWU + PET
dominates

Viney et al
(2002) Australia

a) CT scan (Thorax, upper
abdomen and brain + X
ray)

b) CT scan + PET

Patients
with stage I
and II lung
cancer
potentially
opeperable
(n184)

Cost
effectiveness

Number of futile
thoractomies

Randomised
control trial

b) vs a) 0.22
thoractomies
avoided

b vs a) $A
2,655

b) vs a) $120,681/
thoractomy
avoided

Kosuda et al
(2002)

a) Whole body (WB) PET
b) Conventional imaging +
WB-PET

Potentially
operable
NSCLC

Cost
effectiveness

Life expectancy

Decision
analysis

b) vs a) gain in
LE of minus
0.0246 years to
0.0136 years.

b) vs a) cost
saving of
$951 to
$1,493 per
patient

n/a

34



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