Economic Model Compares Iso-osmolar and Low-Osmolar Contrast Agents in Regard to Cost Associated With Contrast -Induced Acute Kidney Injury
May 29, 2014
Iso-Osmolar Contrast was More Cost-Effective than Low-Osmolar Contrast
Princeton, NJ -- May 29, 2014 -- Results of GE Healthcare-supported economic modeling of a retrospective meta-analysis of published literature were presented today at the SCAI 2014 Scientific Sessions in Las Vegas, NV. The model showed that iso-osmolar contrast media was associated with lower overall cost -- nearly $700 savings per patient - when compared to low-osmolar contrast media in regard to contrast-induced acute kidney injury (CI-AKI).[i]
"Contrast-induced acute kidney injury has major implications including morbidity and health resource utilization," said Swapnil Hiremath, MD, Assistant Professor Medicine in the Division of Nephrology at the University of Ottawa and lead author of the study. "This study provides complementary and supportive CI-AKI data to the recently published meta-analyses by McCullough and Dong comparing contrast-induced nephrotoxicity of iso-osmolar and low-osmolar contrast media and ascribes an economic value to those analyses."[ii],[iii]
About the Study
A systematic review and meta-analysis was conducted to estimate the risk of acute kidney injury after use of iso- and low-osmolar contrast media. A Markov model was then created, taking into account peri-procedural risks, the differential risk of acute kidney injury, the need for dialysis and subsequent mortality risk as well as cost associated with the contrast media itself and treatment for downstream clinical events.
The model showed that use of iso-osmolar contrast resulted in a higher quality adjusted life expectancy (29.19 versus 28.87 quality adjusted life years), in addition to nearly $700 savings per patient. This result was robust across most sensitivity analyses, including cost of contrast media, baseline risk of acute kidney injury, volume of contrast used, risk of dialysis. The exception was the sensitivity analysis with the differential risk of acute kidney injury with iso-osmolar versus low-osmolar contrast media.
"This study shows GE's commitment to the continued advancement of scientific knowledge of iodinated contrast media choice in the interventional field, specifically highlighting health economics," said Jan Makela, General Manager, Core Imaging, GE Healthcare Life Sciences. "We were particularly pleased to find the model reported cost savings for iso-osmolar contrast even when taking into account upfront cost of contrast."
Safety Disclaimer
Serious, life-threatening and fatal reactions, mostly of cardiovascular origin, have been associated with the administration of both iso-osmolar and low osmolar iodine-containing contrast media. Most deaths occur during injection or five to ten minutes later. Rare reports of anaphylaxis have been documented during post-market surveillance. As with other contrast agents, contrast media are often associated with sensations of discomfort, warmth or pain. The reported incidence of adverse reactions to contrast media in patients with a history of allergy is twice that of the general population. Patients with a history of a previous reaction to a contrast agent are three times more susceptible than other patients.
About GE Healthcare
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[i] Hiremath S, Akbari A, Wells G et al. Iso-osmolar Compared to Low-osmolar Contrast Media for Contrast-induced Acute Kidney Injury: A Cost-Effectiveness Analysis. Poster presented at the SCAI 2014 Scientific Sessions, Las Vegas, NV.
[ii] McCullough PA, Brown JR. Effects of Intra-Arterial and Intravenous Iso-Osmolar Contrast Medium (Iodixanol) on the Risk of Contrast-Induced Acute Kidney Injury: A Meta-Analysis Cardiorenal Med 2011;1:220--234
[iii] Dong M, Jiao Z, Liu T, et al. Effect of administration route on the renal safety of contrast agents: a meta-analysis of randomized controlled trials. J Nephrol. 2012 May-Jun;25(3):290-301.
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