Comparative Cost Analysis Research Articles

In-mission synergy of science and navigation ephemeris products—Potential benefits for JUICE statistical Delta-V expenditure and beyond

In 2031 the JUICE spacecraft will perform a multi-flyby tour of the Jovian system. Next to the radiometric tracking that is performed for navigation operations, the dedicated radio science instrument (3GM) collects high-accuracy radiometric measurements during the flybys.We investigate the capability of the radio science data to provide improved moon state knowledge during navigational operations. We introduce ephemeris updates from radio science data into our simulated navigation operations and examine the potential savings of statistical ΔV for corrective manoeuvres. A navigation orbit determination (OD) solution was simulated for the multi-flyby tour of JUICE, including the resulting state knowledge evolution of the Galilean moons. The OD was extended by an interface for external moon ephemeris updates, which was used to evaluate the impact of radio science generated external ephemerides on the statistical ΔV budgets for post-flyby cleanup manoeuvres.The moon state knowledge evolution during navigation operation showed a rapid reduction of the a-priori moon state uncertainty, for which the navigational tracking data coverage of the long, early tour arcs was identified as the driving factor. As a result of the longer tracking arcs, the moon state knowledge from navigation data results improves more quickly during the initial phase of the tour. Since the impact of moon state knowledge on the corrective manoeuvres is largest in this initial phase, the comparative analysis of the statistical ΔV cost shows that the adoption of radio science ephemeris products does not effectuate significant ΔV savings. Instead we showed that in order to achieve substantial ΔV savings improvements of Europa’s and Ganymede’s ephemerides are required ahead of JUICE’s arrival.While the analysis concludes that data synergies are unlikely to benefit the navigational operations, it highlights other potential synergies between the navigation and radio science data. A comparatively strong signature of Io’s dynamics was found in the simulated navigation data along the long early tour arcs, which could be leveraged for the benefit of the new global moon ephemeris solutions after JUICE.

Robot-assisted partial nephrectomy vs. percutaneous cryoablation for T1a renal tumors: a single-center retrospective analysis of outcomes and costs.

The aim of this study is to compare perioperative, functional, and oncological outcomes between robot-assisted partial nephrectomy (RAPN) and cryoablation (CRYO), based on a 3-year experience at our Institution. Additionally, a secondary aim is to conduct a comparative cost analysis between the two procedures. A retrospective analysis was conducted, including patients who underwent RAPN or CRYO between January 2020 and December 2023. Group 1 consisted of 59 patients who underwent RAPN, while Group 2 included 38 patients who had CRYO. The evaluation parameters included baseline characteristics, perioperative, functional, and oncological outcomes, as well as total hospitalization costs. Operative time (OT), average length of hospital stay (LOS), and emetic blood loss (EBL) were significantly lower in the CRYO group. Furthermore, CRYO showed a significantly lower rate of postoperative complications of any grade (7.8% vs 16.9%); however, this was associated with a considerably higher recurrence rate (5.7% vs 1.7%). No substantial differences were found in long-term functional outcomes (ΔeGFR). In terms of costs, CRYO was more cost-effective than RAPN (€5473 vs €10,672), although the gap was partially offset by a higher reimbursement "DRG" rate for robotic partial nephrectomy (€7386 vs €4384). Robot-assisted partial nephrectomy (RAPN) remains the preferred option for treating small renal masses (sRM), providing excellent oncological results and acceptable morbidity. However, percutaneous cryoablation is a valid alternative, particularly for patients unfit for surgery, as long as meticulous postoperative follow-up is carried out.

A methodological framework to model cumulative energy demand and production costs for additive and conventional manufacturing approaches

Additive Manufacturing (AM) processes have undergone a considerable evolution in terms of industrial applicability. From prototyping applications, AM has evolved to become a competitive technology to manufacture end products in comparison with conventional manufacturing. Despite that, the environmental impact advantage of AM is limited to some production scenarios and depends on several factors: high geometric complexity, weight reduction enabled by topology optimisation, light-weight product to be assembled for transportation. Considering production cost, AM process for metal-based components proved to be often more expensive than those produced by conventional approaches. To provide new piece of knowledge in the domain of AM applicability, in this paper a comparative analysis of costs and energy demand for additive, subtractive and mass conserving manufacturing processes is presented and applied to two different Ti-6Al-4V case studies (namely, an axisymmetric and a T-shape component). Turning/milling, hot forging and EBM were analysed and compared one another. The modelling and the results were analysed with varying the product complexity, the batch size, the method for accounting for the credit arising from recycling and the extent of light-weighting obtained by AM application. The result is a framework enabling informed process design and selection with varying production scenarios.

HPB SO13 - Comparative analysis of cost and clinical benefit of Robotic Surgery (RS) vs Laparoscopic Surgery (LS) for the treatment of symptomatic liver cysts

Abstract Background The treatment for symptomatic liver cysts involves the removal of a large portion of the cyst wall (deroofing/fenestration). Robotic surgery (RS) is now used more commonly to treat liver cysts. It is unclear whether RS or laparoscopic surgery (LS) results in superior clinical or economic outcomes. The objective of this study is to compare the cost and clinical benefit of RS vs LS in adults with liver cyst(s). Method Patients meeting inclusion criteria were identified from operating notes and a prospectively held hospital database between 2019 to 2024. Eligible candidates were further investigated for post-operative outcome, length of stay (LOS), subsequent in-person clinic follow-ups for review and removal of drain, and further treatment in patients with recurrence of liver cyst. Financial data for all surgical equipment in RS and LS were provided by sales representatives from the relevant industries. Results Forty-four LS and seven RS patients were analysed. Neither approach recorded a return to theatre. There was no mortality in either group. There was a significantly shorter LOS for RS vs LS patients (median LOS=1 vs 2 days, p<0.05). There was no significant difference in bile leak, drain duration or cyst recurrence between LS and RS. The economic analysis revealed that without taking into account reduced LOS, the costs of RS and LS was £1261.70 and £1733.61 per procedure, respectively. The increased cost in LS was primarily due to multiple stapler firings (median staplers used=5) vs zero staplers in RS. Conclusion Robotic liver cyst surgery is cheaper and provides better clinical outcomes in terms of shorter LOS and reduced complications. Further studies are warranted to examine the long-term cost-effectiveness of RS.

Comparison of surgical effectiveness: kidney sparing surgery for upper tract urothelial carcinoma.

This review provides an overview of the recent publications on kidney-sparing-surgery (KSS) for upper tract urothelial carcinoma (UTUC), an alternative to radical nephroureterectomy (RNU) for an increasing number of indications. Recent studies highlight comparable survival outcomes between KSS [ureterorenoscopy with tumour ablation (URS) or segmental ureteral resection (SUR)] and RNU, even in high-risk UTUC patients. KSS has shown to preserve renal function without significantly compromising oncologic control in appropriately selected patients. Included literature also researched surgical complications, surveillance strategies, such as second-look ureteroscopy, and comparative cost analyses. Over the past two and a half years, studies have emphasized the growing usage of URS and SUR in treating selected UTUC patients. Recent literature has remarkably included relatively large numbers of typically high-risk patients with features such as high-grade tumours, stage >Ta, multifocality, and hydronephrosis with acceptable results. Further research should expand on the different indications for KSS, its postoperative surveillance and comparative economic analyses.

Hospital costs of COVID-19, post-COVID-19 condition and other viral pneumonias: a cost comparison analysis.

To compare hospital admission costs for coronavirus disease 2019 (COVID-19) cases to hospital admission costs for other viral pneumonia cases in Australia, and to describe hospital admission costs for post-COVID-19 condition. A cost comparison analysis of hospital admissions due to COVID-19 or other viral pneumonias between 1 January 2020 and 30 June 2021 at Victorian public health acute and subacute services. Demographic characteristics, clinical outcomes (including diagnoses, impairment, subacute admission, intensive care unit admissions, ventilation, and length of stay) and cost data (including diagnostic-related groups, and total, direct and indirect costs). During the study period, 3197 patients were admitted to hospital due to COVID-19 and 15 761 were admitted for other viral pneumonias. Admissions for COVID-19 cost 29% more than admissions for other viral pneumonias. Admissions for COVID-19 requiring intensive care unit admission incurred significantly higher mean costs (A$120 504 or US$90 595) compared with those not requiring intensive care unit admission (A$19 634 or US$14 761). The adjusted cost of admissions related to post-COVID-19 condition was A$11 090 or US$8 337, and these admissions were significantly more likely to be elective. Direct costs accounted for most of the costs for all groups, and admissions for post-COVID-19 condition used less allied health services than other groups. Given its recent emergence, cases of acute COVID-19 and post-COVID-19 condition have had a significant additional financial impact on Australian hospitals. Further studies are required to understand long term costs and identify trends over time in the context of increased vaccination rates and subsequent variants of severe acute respiratory syndrome coronavirus 2.

The Annual Economic Burden of Uterine Fibroids in the United States (2010 Versus 2022): A Comparative Cost-Analysis.

In 2010, the estimated annual cost of uterine fibroids in the United States ranged from 5.9 to 34.4billion USD. In the past decade, more uterine-sparing and fertility preserving interventions have become available to treat symptomatic fibroids. This comparative cost-analysis aims to evaluate change in societal costs of uterine fibroids in the US between 2010 and 2022 given changing fibroid and obstetric management, population growth, and inflation. A systematic review was conducted to update uterine fibroid, treatment, and obstetric complication prevalence, direct costs of medical and surgical interventions, indirect productivity costs, and obstetric costs attributable to fibroids in 2022. A comparative cost-analysis with paired t-tests was performed using baseline data published in 2010. Percent (%) changes between 2010 and 2022 were reported. NIH research funding for fibroids and other common diseases was compared. All costs were converted to 2023 USD. The number of US women with uterine fibroids increased by 10.6% from 2010 to 2022. Over this period, the economic burden of uterine fibroids increased up to 41.4billion USD compared to 34.4billion USD in 2010. Overall costs increased to 42.2billion USD after incorporating new costs associated with MRgFUS and infertility. Direct costs of medical management decreased while costs of surgical interventions increased as a result of evolving treatment-seeking behavior. Lost work costs continue to account for the largest proportion of the economic burden for fibroids. Cesarean section delivery remains the largest contributor (average 80.0%) to indirect obstetrical costs. Despite the rise in the number of individuals affected by uterine fibroids and its sizable annual cost to society, uterine fibroids research continues to be underfunded.

Cost of Illness Studiesin clinical depression Using Discounting Methods: A Comprehensive Analysis

Abstract:This research delves into the intricate domain of Cost of Illness (COI) studies, also known as Burden of Disease (BOD), with a specific focus on depressive disorders. Employing a bottom-up approach, the study meticulously scrutinizes the economic implications of depression at various levels, emphasizing direct and indirect costs. The analysis integrates a detailed exploration of diverse discounting methods, including Net Present Value (NPV) and Discounted Cash Flow (DCF), with a particular emphasis on the Indian context to comprehend unique socio-economic factors.Methodologically, the study systematically reviews scientific literature over the past decade, utilizing databases such as Web of Science and Google Scholar. The inclusion criteria prioritize patient-based studies related to the cost of illness associated with depression. The research adopts a comprehensive approach, considering various methodologies and discounting techniques to enhance the understanding of economic implications.The comparative analysis of the total cost of illness across diverse countries unravels significant variations, highlighting the intricate nature of healthcare expenditures and economic structures. Specific breakdowns for each country consider factors suchas currency exchange rates, inflation, and Purchasing Power Parity (PPP) adjustments, shedding light on the complexities involved.The study across five countries highlights significant variations in depression-related costs. Direct medical costs have a mean of $42,668 (SD=16,940) with a high t-statistic of 27.83 (p-value 0.001), emphasizing substantial differences. Direct non-medicalcosts average $27,171 (SD=13,220) with a t-statistic of 14.07 (p-value 0.001), indicating a notable economic burden beyond medical expenses. Indirect costs related to depression stand at a mean of $63,816 (SD=25,230), with a t-statistic of 35.30 (p-value 0.001), highlighting significant impacts on productivity and societal costs. The total cost of illness, encompassing both direct and indirect costs, averages $113,590 (SD=43,990), with a t-statistic of 49.49 (p-value 0.001), reflecting the extensive economic implications of depression across these diverse nations.In conclusion, this comprehensive analysis contributes depth to our understanding of the economic impact of depressive disorders, providing valuable insights for policymakers, healthcare providers, and researchers. The research underscores the multifacetednature of the economic burden of depression, emphasizing variations across countries and advocating for comprehensive, context-specific approaches in assessing and addressing global implications. Acknowledging challenges with discounting methods, the paper identifies opportunities for refining methodologies and improving economic evaluations in the future, emphasizing the importance of nuanced insights for effective policymaking and healthcare strategies on a global scale.

Cost and resource comparison analysis for THA in Switzerland and Austria.

Total hip arthroplasty (THA) is an orthopedic intervention that generates substantial costs to national healthcare systems due to the number of interventions and the cost per intervention. We performed a cost comparison analysis in Austria and Switzerland. Data from the national joint arthroplasty register in Switzerland and internal information from the national healthcare services in Austria and Switzerland were compared for patient demographics, interventional characteristics, and costs adjusted for inflation and purchasing power from 2015 to 2021. The average age for primary THA in Austria was from 67.4 to 67.8years with 55.9-57.2 percent female patients and from 68.5 to 69.3years with 52.4-53.8 percent female patients in Switzerland. The annual incidence rate for primary THA rose from 210.28/100k to 216.6/100k in Austria and from 212/100k to 250/100k in Switzerland. After correction for inflation, costs were -1.91 percent lower in Austria in 2021 than in 2015 and -2.57 percent lower in Switzerland. After correction for purchasing power, costs were higher in Austria. The average hospital stay after THA in Austria was reduced by 20 percent (11.7days/2015 vs. 9.4days/2021) and 25 percent in Switzerland (8.4days/2015 vs. 6.4days/2021). Revision rate was 2.5-3.2 percent in Austria and 2.8-3.2 percent in Switzerland. The patient population was comparable while patients undergoing primary THA in Austria stay longer in hospital and have relatively higher costs when adjusted for currency, purchasing power, and inflation. The use of standardized registers would be helpful to compare outcomes and costs.

Long-Term Comparative Life Cycle Assessment, Cost, and Comfort Analysis of Heavyweight vs. Lightweight Construction Systems in a Mediterranean Climate

Massive construction systems have always characterized traditional architecture and are currently the most prevalent, straightforward, and cost-effective in many Mediterranean countries. However, in recent years, the construction industry has gradually shifted towards using lightweight, dry construction techniques. This study aims to assess the effects on energy consumption, comfort levels, and environmental sustainability resulting from the adoption of five high-performance construction systems in a multi-family residential building: (i) reinforced concrete structure with low-transmittance thermal block infill; (ii) reinforced concrete structure with light-clay bricks and outer thermal insulation; (iii) steel frame; (iv) cross-laminated timber (CLT); (v) timber-steel hybrid structure. To achieve this goal, a multidisciplinary approach was employed, including the analysis of thermal parameters, the evaluation of indoor comfort through the adaptive model and Fanger’s PMV, and the quantification of environmental and economic impacts through life cycle assessment and life cycle cost applied in a long-term analysis (ranging from 30 to 100 years). The results highlight that heavyweight construction systems are the most effective in terms of comfort, cost, and long-term environmental impact (100 years), while lightweight construction systems generally have higher construction costs, provide lower short-term environmental impacts (30 years), and offer intermediate comfort depending on the thermal mass.

Incremental Cost Benefit Ratio (ICBR) of Poly House and Open Field Conditions in Cabbage (Brassica oleracea var. capitata) after Chemical Intervention

This study evaluates the Incremental Cost Benefit Ratio (ICBR) between Poly house and Open field conditions in cabbage cultivation chemical intervention. The research aimed to compare the economic feasibility of adopting poly house technology over traditional open field methods, considering costs and benefits associated with chemical inputs. A comparative cost analysis was conducted to assess production expenses like costs for insecticidal treatments and labor charges. Yield data from both environments were collected to determine output differences and subsequent economic returns. Results indicate that Incremental cost benefit ratio of cabbage heads yields to the cost of treatments in poly house and open field presented as there was a significant superior difference in ICBR ratio of poly house with 1: 0.946 as compared to open field with 1: 0.639 of cabbage heads. The economic analysis revealed that the higher yields and quality achieved in poly house conditions due to less dissipation and undisturbed environmental factors on insecticide applied. Resulting in a favorable incremental Cost benefit ratio compared to open field cultivation.

Comparative Life Cycle Assessment and Life Cycle Cost Analysis of Bonded Nd-Fe-B Magnets: Virgin Production versus Recycling

Comparative Life Cycle Assessment and Life Cycle Cost Analysis of Bonded Nd-Fe-B Magnets: Virgin Production versus Recycling

The treatment gap for deep brain stimulation in Parkinson's disease: a comparative analysis of cost and utilisation in high-income countries.

ObjectiveParkinson's disease (PD) is one of the most prevalent neurodegenerative disorders, globally affecting approximately 120 per 100,000 people by age 70. Deep brain stimulation (DBS) is a US Federal Drug Administration (FDA)-approved and highly effective treatment for late-stage PD. However, country-specific reimbursement regulations and health policies may affect access to PD-DBS. We aimed to evaluate the uptake rate and 'treatment gap' for DBS across high-income countries.MethodsWe reviewed previous literature to investigate the cost and utilisation of PD-DBS in high-income countries across Asia, Europe, Oceania, and North America (Australia, Canada, France, Germany, Hong Kong, Japan, Korea, the Netherlands, New Zealand, Norway, Spain, Switzerland, UK, and USA). Using previous estimates of DBS candidate eligibility rates, we calculated theoretical DBS uptake rates and treatment gaps nationally.ResultsPD-DBS utilisation was highest in Australia and the USA and lowest in Korea and New Zealand. The total cost of PD-DBS in the first 12months was highest in the USA and France and lowest in the UK and Germany. The utilisation rate (i.e. uptake rate) of PD-DBS (% DBS surgeries per PD case) was highest in Australia and the USA, and lowest in New Zealand and the UK, where the treatment gap reflected these trends.ConclusionsOur results highlight differences in access to DBS for PD patients among high-income countries, which we discuss in the context of health systems. Better access to effective PD treatments such as DBS is critical given the increasing prevalence of PD in an ageing world and the associated, avoidable morbidity.

The first engineering application of 10MN CFRP cables in cable-stayed bridge in China

Existing engineering applications typically involve carbon fiber reinforced polymers (CFRP) cables with relatively small ultimate tensile forces (less than 10MN). This study presents the engineering application of China's first thousand-ton-grade CFRP cable-stayed bridge. The optimal steel and CFRP hybrid cable system was determined through a comparative analysis of structural behavior and life cycle cost. Thereafter, the CFRP cable, consisting of 121 strands of φ7 CFRP tendons, along with its anchoring system, was designed and manufactured with a theoretical ultimate tensile strength of 10,710 kN (Pb). Subsequently, the mechanical properties of 7–121 CFRP cable were investigated and experimentally verified. The tensile test revealed a satisfied ultimate tensile bearing capacity of 10,805 kN. Furthermore, after two million fatigue cycles, the CFRP cables retained approximately 90 % of their theoretical ultimate force, highlighting their excellent fatigue resistance. Besides, no damage occurred with a maintained tension force of 0.45 Pb at a temperature of 150 °C for a duration of at least 30 min, meeting the requirements of specification. Moreover, the key procedures of CFRP cable installation were also claimed. This study aims to further promote the application and development of CFRP cables in larger span and even super-long span bridges.

Cost comparison analysis of continuous versus intermittent antimicrobial therapy infusions in inpatient and outpatient care: real-world data from Finland

ObjectiveThis study compared the costs and nursing time associated with the delivery of continuous infusion of antibiotics via elastomeric infusion pumps (EIP) versus conventional intermittent infusion (CII) across different care...

Comparative Analysis of Reliability, Cost and Performance of Three and Five-Phase Synchronous Reluctance Machine Drive Systems With and Without Permanent Magnets

Comparative Analysis of Reliability, Cost and Performance of Three and Five-Phase Synchronous Reluctance Machine Drive Systems With and Without Permanent Magnets

Carbon neutrality and energy production in the UAE: Challenges and opportunities for the petrochemical industries

This study analyzes the strategic impacts of the UAE's push towards diversifying its petroleum industry on international petrochemical companies. The research focuses on the UAE's investments and supportive policies, highlighting the need for international firms to shift strategies by developing high-value-added products, enhancing productivity through carbon reduction and digital technologies, and diversifying export markets. Methodologies include a comparative analysis of production costs and market competitiveness. Key findings reveal the potential for hydrogen imports from the UAE due to lower production costs of blue and green hydrogen compared to Europe, advocating for a diversified hydrogen sourcing strategy. The study underscores the importance of international cooperation for technological advancement and carbon reduction, proposing joint ventures and collaborative research as pathways to enhance global competitiveness and create employment.

Estimation of the Economic and Environmental Impact of Single-Use Instruments in Routine Cataract Surgery.

To estimate the economic and environmental impact of single-use instruments (SUIs) to perform standard cataract surgery in six ophthalmology centers located in Europe and in the United States. Online survey and interview. Comparative cost analysis based on an online survey with follow-up questionnaire and interview. The carbon footprint calculation was made by ClimatePartner. Annual costs of reusable instruments (RUIs) were calculated based on data provided by the centers. Annual costs of SUIs were estimated based on the average-selling price of a single-use cataract set of 5 instruments and the reported annual volume of cataract surgery. The calculation carbon footprint of a cataract instrument covered the whole life cycle from production to end-of-life. Annual costs for SUIs were found inferior or similar to the annual costs for RUIs for 4 out of the 6 centers included in this study. The centers where SUIs were demonstrated to be the most cost-effective were also associated with the highest costs of sterilization per instrument. The carbon footprint of 5-years usage of a cataract instrument was found to be 5478.2 kg CO2 eq for SUIs without recycling, 4639.9 kg CO2 eq for SUIs with recycling and 20.6 kg CO2 eq for RUIs. The study demonstrated that SUIs can be an alternative solution to using RUIs in multispecialty hospitals associated with high sterilization costs.

The Challenges of Naval Electromobility in Amazônia

Introduction: This study aims to assess the feasibility of replacing a diesel-powered tourist boat with a Solar Electric Hybrid Catamaran with a capacity for fifty people to promote sustainable tourism in the Amazon, specifically in the Belém-Pará region. The initiative seeks to take advantage of the opportunity presented by COP 2030 to innovate in the waterway transportation matrix through renewable energy sources. The research is based on sustainability concepts, the environmental impacts of using fossil fuels and the advantages of using solar energy for waterway transportation. The methodology includes a comparative analysis of diesel-powered vessels' operational and environmental costs and a Hybrid Electric system based on data compiled from a master's thesis. The expected results include identifying significant benefits in terms of reduced carbon emissions. The discussion will address the challenges faced in implementation, such as the initial investment costs, the maintenance of the new technologies, and the adaptation of operators and tourists to the latest transportation conditions. The implications of this research are vast; it can serve as an incentive for energy transition in the river transportation sector. Furthermore, this research pioneers the proposal of replacing diesel-powered tourist boats with solar electric hybrid models in the Amazon region. The study adds value by presenting a practical and sustainable solution to the environmental challenges the tourism sector faces, in line with the global sustainability goals set by COP 2030. Objective: This research outlines the importance and potential of naval electric mobility in the Eastern Amazon region, highlighting its relevance within COP 2030 and the SDGs for promoting ecotourism for the Amazon region. Theoretical Framework: The research is based on sustainability concepts, the environmental impacts of using fossil fuels, and the advantages of using solar energy for water transportation. In addition, previous experiences of implementing similar technologies in other regions and the potential for replicability in the Amazon are considered, focusing on environmental conservation and economic development. Method: This research is a compilation of the master's thesis entitled "Waterway electric propulsion technologies: conceptual design of a hybrid vessel with a focus on meeting environmental, social and Governance (ESG) practices," where the study was carried out in the municipality of Belém, Pará in the year 2023. Results and Discussion: The expected results include identifying significant benefits in terms of reduced carbon emissions, lower noise pollution and improved air quality. The discussion will address the challenges faced in implementation, such as initial investment costs, maintaining the new technologies and adapting operators and tourists to the new transportation conditions. Social acceptance and the potential for a positive impact on local tourism will also be assessed. Research Implications: This research has vast implications, ranging from contributing to climate change mitigation to promoting more sustainable tourism practices in the Amazon. Adopting the Solar Electric Hybrid Catamaran can serve as a model for other areas with similar geographical characteristics, encouraging public policies aimed at using renewable energies in the transportation sector. Originality/Value: This research pioneers the proposal of the replacement of diesel-powered tourist boats with a solar electric hybrid model in the Amazon region. The study adds value by presenting a practical and sustainable solution to the environmental challenges faced by the tourism sector, which is in line with the global sustainability goals set by COP 2030.

Cost containment analysis of superparamagnetic iron oxide (SPIO) injection in patients with ductal carcinoma in situ

PurposeRecent studies have established the safety and efficacy of Superparamagnetic Iron Oxide (SPIO, Magtrace®) for delayed sentinel lymph node biopsy (SLNB) in patients with ductal carcinoma in situ (DCIS) who are undergoing mastectomy. The aim of our study was to measure cost containment with use of Magtrace® in comparison to upfront SLNB with traditional technetium-99 lymphatic tracer.MethodsA total of 41 patients at our institution underwent mastectomy with Magtrace® injection for DCIS and were included in our single-institution, retrospective analysis. For comparison, total charges data were obtained for an upfront SLNB at the time of mastectomy. Cost comparison analysis was then performed against charges for intraoperative Magtrace® injection with additional charges incorporated for those patients who required return to the operating room for delayed SLNB. Total cost containment for the cohort with use of Magtrace® was then measured.ResultsOf the 41 patients who underwent Magtrace® injection, two patients required return to the operating room for a delayed SLNB for invasive disease. Including these charges for a second encounter into our cost analysis, the use of Magtrace® still yielded an overall cost containment of $205,793.55 in our cohort when comparing to patients who underwent upfront SLNB. For patients who underwent Magtrace® injection and did not require return to the operating room, charges were reduced by $6,768.52 per patient.ConclusionThe use of Magtrace® for delayed SLNB in patients with DCIS undergoing mastectomy yielded a significant overall cost containment, further supporting its use in this patient population.