Cost effectiveness of stress only gated myocardial perfusion SPECT following normal stress scintigraphy findings

In Australia, approximately 70000 myocardial perfusion SPECT studies are performed annually, costing in excess of $51 million. Eliminating the rest study in the presence of a normal stress study may potentially save millions of dollars annually.Methodology: This study was a retrospective cost effectiveness analysis that examined the potential of eliminating the rest study when the initial gated stress study is normal in both perfusion and function. Decision tree analysis was performed to determine the cost effectiveness of this approach compared to the more traditional rest and stress procedure.Results: 100% (174/174) of normal stress studies were associated with a normal rest study. Decision tree analysis demonstrated a potential saving of $3600000 annually without compromising patient management or outcomes.Conclusion: Eliminating the rest image when the initial stress image is normal in both perfusion and function provides a positive cost benefit relationship without risking diagnostic integrity of the procedure. Additionally, eliminating the rest study reduces radiation exposure, reduces the time commitment of patients and potentially reduces waiting lists in busy department; increasing marginal profits.