Investing in new technology: the PET experience

Area of Science:

• Health Technology Assessment
• Diagnostic Imaging
• Health Economics

Background:

• Limited health service funding necessitates demonstrating cost-effectiveness for new technologies.
• Diagnostic technologies pose challenges for traditional randomized controlled trial (RCT) evaluation.
• Existing literature on FDG-PET imaging in cancer management primarily reports diagnostic accuracy, not patient outcome improvements.

Purpose of the Study:

• To assess the cost-effectiveness and patient benefits of introducing FDG-PET imaging in the NHS in Scotland.
• To address the challenges in evaluating diagnostic technologies where RCTs are not appropriate.
• To determine if FDG-PET imaging meets NHS criteria for cost-effectiveness and patient benefit.

Main Methods:

• Conducted a Health Technology Assessment (HTA) of FDG-PET imaging.
• Synthesized evidence from diverse sources through interdisciplinary collaboration.
• Developed decision models to estimate long-term patient outcomes and cost-effectiveness.

Main Results:

• FDG-PET imaging was determined to be likely cost-effective in selected cancer management applications.
• Identified significant long-term patient benefits not feasible to study via RCTs.
• Decision models provided a viable alternative for evaluating technologies lacking RCT evidence.

Conclusions:

• Interdisciplinary decision modeling is essential for evaluating the cost-effectiveness of diagnostic technologies like FDG-PET.
• FDG-PET imaging offers potential long-term patient benefits and cost-effectiveness in specific cancer applications.
• HTA using decision models can inform healthcare policy for new diagnostic technologies.