Microcosting Study of Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Prostate Cancer

Bonny Parkinson; Rajan Sharma; Varinder Jeet; Rachel Song; Martin Hoyle

doi:10.1016/j.vhri.2022.06.005

Microcosting Study of Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Prostate Cancer

Value Health Reg Issues. 2022 Nov:32:17-22. doi: 10.1016/j.vhri.2022.06.005. Epub 2022 Aug 11.

Authors

Bonny Parkinson¹, Rajan Sharma², Varinder Jeet², Rachel Song², Martin Hoyle²

Affiliations

¹ Macquarie University Centre for the Health Economy, Macquarie University, Sydney, NSW, Australia; Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia; Macquarie Business School, Macquarie University, Sydney, NSW, Australia. Electronic address: bonny.parkinson@mq.edu.au.
² Macquarie University Centre for the Health Economy, Macquarie University, Sydney, NSW, Australia; Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia; Macquarie Business School, Macquarie University, Sydney, NSW, Australia.

PMID: 35963186
DOI: 10.1016/j.vhri.2022.06.005

Abstract

Objectives: Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) has emerged as a promising imaging tool in prostate cancer diagnosis. PSMA PET/CT radiotracers are produced in-house (gallium-68, eg, ⁶⁸Ga-PSMA-11) or provided by commercial entities (fluorine-18, eg, ¹⁸F-DCFPyL). Nevertheless, the cost per procedure is not well established given that current estimates have several limitations. This study aimed to establish the cost of PSMA PET/CT in Australia.

Methods: Hospitals and diagnostic facilities currently conducting PSMA PET/CT in Australia in metropolitan and regional areas completed a survey of PSMA PET/CT throughput, radiotracers involved, and the cost of assets, departmental staffing, consumables, and occupancy. Total costs were estimated using a top-down microcosting approach, involving identifying all relevant cost components and valuing each component for the average patient, and a gross costing approach, involving apportioning cost components at an aggregated level.

Results: Data were collected from 8 facilities. The most common radiotracer used was ¹⁸F-DCFPyL (7 facilities, 87%), followed by ⁶⁸Ga-PSMA-11 (4 facilities, 50%). The average cost of PSMA PET/CT was A$1554.77 and A$1306.00 based on the microcosting and gross costing approaches, respectively.

Conclusions: This study provides a detailed and accurate estimation of the cost of PSMA PET/CT in Australia. These costs can be used as a benchmark to identify potential efficiencies and help policy makers set the appropriate reimbursement rate for this procedure. The use of data from facilities using different radiotracers in metropolitan and regional areas and with different throughput increases the generalizability of the results, especially in countries with similar health systems.

Keywords: Australia; computed tomography; costs; imaging; positron emission tomography; prostate cancer; prostate-specific membrane antigen; prostatic neoplasms.

MeSH terms

Gallium Isotopes
Humans
Male
Positron Emission Tomography Computed Tomography* / methods
Prostate
Prostatic Neoplasms* / diagnostic imaging

Substances

gallium 68 PSMA-11
Gallium Isotopes