A cost-utility analysis of 18F-fluorocholine–positron emission tomography imaging for localizing primary hyperparathyroidism in the United States

The impact of perioperative diagnostic tools on clinical outcomes and cost-effectiveness in parathyroid surgery: a health economic evaluation

“…Our analysis demonstrated that 4D-CT was the least expensive preoperative imaging modality, while both SPECT/CT and ultrasound were more expensive and provided fewer QALYs than 4D-CT. FCH-PET/CT was superior to 4D-CT in terms of the QALYs gained and is likely cost-effective below a $85,000 WTP threshold. Our results were consistent with the most recent cost-effectiveness analysis 14 despite using more conservative estimates for the diagnostic performance parameters for several preoperative localization strategies (ultrasound, Sestamibi-SPECT/CT, and 4D-CT) from the latest meta-analyses. A plausible explanation for reaching a comparable conclusion might lie in the inclusion of MGD cases in our study, for which the preoperative localization is considerably less accurate.…”

“…13 Some recent cost-effectiveness analyses focused only on preoperative imaging modalities without considering the inclusion of patients with MGD and reoperations. 14 Other health economic evaluations only assessed the cost of preoperative localization and ioPTH monitoring, omitting the clinical outcomes. 12 The absence of a complete evidence on the clinical benefits and cost-effectiveness of using either criterion for the ioPTH evaluation contributes to the lack of consensus on whether the use of ioPTH monitoring is warranted and what criterion should be for solitary adenomas and MGD.…”

[18F]Fluorocholine PET/CT as First-Line vs. Second-Line Imaging Method to localize parathyroid adenomas in primary hyperparathyroidism: “Game, Set, and Match”

“…A previous cost-utility analysis by Yap et al on [ 18 F]Fluorocholine PET/CT demonstrated that this imaging method is potentially a cost-effective imaging technique in the United States if compared to other imaging methods used in primary HPT [14]. However, the comparators in the studies of Yap et al and van Mossel et al are different [13,14].…”

“…A previous cost-utility analysis by Yap et al on [ 18 F]Fluorocholine PET/CT demonstrated that this imaging method is potentially a cost-effective imaging technique in the United States if compared to other imaging methods used in primary HPT [14]. However, the comparators in the studies of Yap et al and van Mossel et al are different [13,14]. In particular, van Mossel et al better compared first-line [ 18 F]Fluorocholine PET/CT vs. second-line [ 18 F]Fluorocholine PET/CT after negative or inconclusive conventional imaging, thus better considering the influence of sequential imaging.…”

“…In particular, van Mossel et al better compared first-line [ 18 F]Fluorocholine PET/CT vs. second-line [ 18 F]Fluorocholine PET/CT after negative or inconclusive conventional imaging, thus better considering the influence of sequential imaging. The two cost-effectiveness analyses also differ on cost-effectiveness outcome (incremental QALYs benefit) and costs which can be explained by the different modelling methods used and the different tariffs of imaging methods and therapies within the American and European healthcare systems [13,14].…”