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- Title
Custo-efetividade do uso da tomografia de emissão de pósitrons na detecção de recorrência do câncer diferenciado de tireoide.
- Authors
Caetano, Rosângela; Biz, Aline Navega; Schluckebier, Luciene Fontes; da Silva, Rondineli Mendes; Braga, José Ueleres; Garcia Bastos, Cláudia Regina
- Abstract
The positron emission tomography (18FDG-PET/CT) was recently introduced in Brazilian health care for many oncology indications but accompanied by higher costs. In our study we performed a cost-effectiveness analysis of the addition of PET/CT to the conventional diagnostic work-up to detect recurrent differentiated thyroid cancers. The analytical decision model represented a hypothetical cohort of adults, thyroid cancer patients with high risk by initial stratification, submitted to total thyroidectomy and ablation with I131. The addition of PET/CT was applied to subjects with negative results on I131scintigraphy. The model was designed from the perspective of the Brazilian public health care system, with a time horizon of 10 years. Effectiveness was measured by the additional recurrent cases detected. Only direct medical costs were considered. Costs and benefits were discounted by 5%. Univariate deterministic and probabilistic sensitivity analyzes were performed to explore the uncertainties. The PET/CT diagnosed 13 additional cases compared to conventional strategy (1,888 vs 1,875) by a cost of R$477,633.05 per case detected. The parameters of greatest impact in the sensitivity analysis were the accuracy of conventional tests, cost of PET/CT and the discount rate. The costs of adding PET/CT seems significant and its introduction is not cost-effective on the Brazilian perspective.
- Publication
Physis: Revista de Saúde Coletiva, 2016, Vol 26, Issue 1, p331
- ISSN
0103-7331
- Publication type
Article
- DOI
10.1590/S0103-73312016000100018