Abstract
The US standard of care for traumatic brain injury (TBI) diagnosis and management is computed tomography (CT) and magnetic resonance imaging (MRI). This study examined the annual utilization, per unit and per veteran, Veterans Health Administration (VHA) costs of CT and MRI in US veterans with TBI over a 14-year period, arrayed by TBI severity. This study also investigates the comorbidity and TBI severity-adjusted marginal impact of CT and MRI use on total, inpatient, outpatient, and pharmacy (VHA) cost of these veterans. Currently, there is one US Food and Drug Administration (FDA)-approved TBI blood biomarker, and one internationally approved TBI blood biomarker in Sweden. Pricing for the FDA-approved biomarker has not been established. The results of our investigation provide benchmark information for economic evaluation of TBI blood biomarkers. They also show that veterans with mild TBI severity have a higher use of any MRI, relative to higher TBI severity. Finally, the results show that while having a higher per unit cost, MRI use is associated with a significant reduction in annual inpatient VHA costs of approximately double the MRI’s per-unit cost. This finding has important implications for MRI use guidelines as well as benchmark information for TBI blood biomarkers.
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