Cost-effectiveness of neuroimaging technologies in management of psychiatric and insomnia disorders: A meta-analysis and prospective cost analysis - 03/01/21

Doi : 10.1016/j.neurad.2020.12.003

Zhila Najafpour ^a,⁎ , Asieh Fatemi ^b , Zahra Goudarzi ^c , Reza Goudarzi ^d , Kamran Shayanfard ^e , Farsad Noorizadeh ^f
^a Department of Health Care Management, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
^b Dpartment of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Faculty of Paramedical sciences, Rafsanjan University of Medical Sciences, Iran
^c Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
^d Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
^e University of Luxembourg, Luxembourg
^f Basir Eye Health Research Center, Exceptional Talents Development Center, Tehran University of Medical Sciences, Tehran, Iran

^⁎Corresponding author at: Health care Management group, Public Health Faculty, Ahvaz Jundishapur University of Medical Sciences, Golestan Street, Ahvaz, Iran.Health care Management groupPublic Health FacultyAhvaz Jundishapur University of Medical SciencesGolestan StreetAhvazIran

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Sunday 03 January 2021
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Abstract

Background

The optimal diagnostic strategy for patients with psychiatric and insomnia disorders has not been established yet.

Purpose

The purpose of this study was to perform cost-effectiveness analysis of six neuroimaging technologies in diagnosis of patients with psychiatric and insomnia disorders.

Methods

An economic evaluation study was conducted in three parts, including a systematic review for determining diagnostic accuracy, a descriptive cross-sectional study with Activity-Based Costing (ABC) technique for tracing resource consumption, and a cost-effectiveness analysis using a short-term decision-analytic model.

Results

In the first phase, 93 diagnostic accuracy studies were included in the systematic review. The accumulated results (meta-analysis) showed that the highest diagnostic accuracy for psychiatric and insomnia disorders was attributed to PET (sensitivity of 90% and specificity of 80%) and MRI (sensitivity of 76% and specificity of 78%) respectively. In the second phase of the study, we calculated the cost of each technology. The results showed that MRI has the lowest cost. Based on the results in the model of cost-effectiveness sMRI ($ 50.08 per accurate diagnosis) and MRI ($ 58.54 per accurate diagnosis) were more cost-effective neuroimaging technologies.

Conclusion

In psychiatric disorders, no single strategy was characterized by both low cost and high accuracy. However, MRI and PET scan had lower cost and higher accuracy for psychiatric disorders, respectively. MRI was the least costly with the highest diagnostic accuracy in insomnia disorders. Based on our model, sMRI in psychiatric disorders and MRI in insomnia disorders were the most cost-effective technologies.

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Abbreviations : PET, MRI, SPECT, fMRI, MDD, rs-fMRI, DOR, ICER, ABC

Keywords : Cost-effectiveness, Neuroimaging, Diagnosis, Sensitivity, Specificity, Psychiatric disorders, Insomnia disorders