Cost-effectiveness of MR angiography in cases of limb-threatening peripheral vascular disease.

Abstract

To evaluate the cost-effectiveness of magnetic resonance (MR) angiography in the preoperative planning of treatment in patients with limb-threatening peripheral vascular disease (PVD). A decision model was developed to study the effects of MR angiography on the outcome and cost of treatment. The authors calculated the incremental cost per quality-adjusted life-years gained (ie, cost-effectiveness ratio) when conventional angiography was replaced or supplemented with MR angiography. Previously reported data regarding the accuracies of MR and conventional angiography were used in the analysis. The cost-effectiveness ratio of MR angiography ranged from negative (cost-reducing) values to $78,000. For the base case in which the sensitivity and specificity of MR angiography for the evaluation of inflow vessels were 92% and 88% and those of conventional angiography were 97% and 97%, respectively, the cost-effectiveness ratio was $25,895. MR angiography may be a cost-effective alternative to conventional angiography in patients with limb-threatening PVD if its accuracy for the inflow evaluation reaches certain thresholds. Further prospective investigation is warranted.