Cost-Minimization Analysis of Multidose and Single-Dose Packaging of Contrast Media for Contrast-Enhanced CT: Results From Real-World Data in China.

Abstract

OBJECTIVE. Utilization and waste in diagnostic imaging have substantially increased worldwide. The purpose of this study was to highlight the utilization of contrast material and cost savings resulting from implementation of a multidose bulk IV contrast delivery system. MATERIALS AND METHODS. An observational study was conducted in October-November 2018 in eight hospitals in eight provinces in China. Contrast media specifications were 100-mL single-use IV contrast vials and 200-mL and 500-mL bulk packaging. Linear regression analysis was performed to identify the factors influencing contrast media use. Cost-minimization and sensitivity analyses were performed from patient and payer perspectives. RESULTS. A total of 1032 patients, some of whom underwent more than one CT examination, were enrolled in this study (100-mL package, 776 CT examinations; 200-mL package, 382 CT examinations). The mean injected volume of contrast medium was 75.46 mL. Number of scanned body parts, specification of amount of contrast medium (0, 100 mL; 1, 200 mL), whether the examination was CT angiography (CTA) (0, not CTA; 1, CTA), and patient weight all had a positive impact on the injected volume of contrast medium (p < 0.001 for all variables). Implementation of a multidose bulk IV contrast delivery system combined with different reimbursement units resulted in substantial waste reduction, estimated at US$5.59-6.04 per contrast-enhanced CT examination from the payer perspective, US$12.84-14.66 per examination from the patient perspective, and a total reduction of US$18.29-20.70 per examination. CONCLUSION. Use of multidose packaging of contrast media combined with reimbursement units for patients undergoing IV contrast-enhanced CT was found to be cost saving compared with use of single-dose packaging.