Adenosine and dipyridamole in nuclear imaging: pharmacoeconomic considerations

Adenosine and dipyridamole are coronary vasodilators used in nuclear imaging. The acquisition cost of adenosine is four to ten times higher than dipyridamole. Data suggest comparable sensitivity, although specificity may be lower with dipyridamole. While side effect profiles are similar, fewer patients who receive adenosine require medical intervention to manage their side effects. Only three pharmacoeconomic evaluations comparing adenosine and dipyridamole are available - the data are limited by the methodology and study design. Two studies found that total costs with adenosine were lower compared with dipyridamole. In contrast, the interim results of an evaluation conducted with generic dipyridamole found that total costs were higher with adenosine than with dipyridamole - the final results are awaited. In addition, evaluations of downstream costs are needed to clarify the economic implications of a lower specificity with dipyridamole.