Low Osmolar Contrast Agents: Pharmacoeconomic and Medicolegal Issues Surrounding Their Use

Abstract

Most healthcare experts agree that there is a growing disparity between the availability of technology and society's ability to pay for it. Because consumerism in healthcare has become so intimidating to many practitioners, they are often compelled to provide the best, most highly advanced technologies available, regardless of their costs, to all patients. As one study notes, “technological advance is the dominant factor in the upward spiral in healthcare costs.” There is general agreement that some controls must be placed on our healthcare expenditures as evidenced by the call for “healthcare reform.” In this article, one group of pharmaceuticals used in diagnostic imaging, low osmolar contrast media (LOCM), and their impact on healthcare are considered. These relatively new radiopaque contrast agents are equally effective for diagnosis and apparently somewhat safer than the traditional high osmolar contrast media (HOCM). One striking difference between the two categories of contrast agents is that the LOCM cost approximately 15 to 25 times that of the HOCM. This example provides an excellent illustration of the concerns related to cost and benefit in healthcare, and raises many medical, legal, economic, and public policy questions that are addressed in this article.