Pandya, AnkurYu, Yuan-JuiGe, YinNagel, EikeKwong, Raymond Y.Bakar, Rafidah A.Grizzard, John D.Merkler, Alexander E.Ntusi, NtobekoPetersen, Steffen E.Rashedi, NinaSchwitter, JuergSelvanayagam, Joseph B.White, James A.Carr, JamesRaman, Subha V.Simonetti, Orlando P.Bucciarelli-Ducci, ChiaraSierra-Galan, Lilia M.Ferrari, Victor A.Bhatia, MonaKelle, Sebastian2022-01-092022-01-092022-01-06Journal of Cardiovascular Magnetic Resonance. 2022 Jan 06;24(1):1http://hdl.handle.net/1880/114265https://doi.org/10.11575/PRISM/45921Abstract Background Although prior reports have evaluated the clinical and cost impacts of cardiovascular magnetic resonance (CMR) for low-to-intermediate-risk patients with suspected significant coronary artery disease (CAD), the cost-effectiveness of CMR compared to relevant comparators remains poorly understood. We aimed to summarize the cost-effectiveness literature on CMR for CAD and create a cost-effectiveness calculator, useable worldwide, to approximate the cost-per-quality-adjusted-life-year (QALY) of CMR and relevant comparators with context-specific patient-level and system-level inputs. Methods We searched the Tufts Cost-Effectiveness Analysis Registry and PubMed for cost-per-QALY or cost-per-life-year-saved studies of CMR to detect significant CAD. We also developed a linear regression meta-model (CMR Cost-Effectiveness Calculator) based on a larger CMR cost-effectiveness simulation model that can approximate CMR lifetime discount cost, QALY, and cost effectiveness compared to relevant comparators [such as single-photon emission computed tomography (SPECT), coronary computed tomography angiography (CCTA)] or invasive coronary angiography. Results CMR was cost-effective for evaluation of significant CAD (either health-improving and cost saving or having a cost-per-QALY or cost-per-life-year result lower than the cost-effectiveness threshold) versus its relevant comparator in 10 out of 15 studies, with 3 studies reporting uncertain cost effectiveness, and 2 studies showing CCTA was optimal. Our cost-effectiveness calculator showed that CCTA was not cost-effective in the US compared to CMR when the most recent publications on imaging performance were included in the model. Conclusions Based on current world-wide evidence in the literature, CMR usually represents a cost-effective option compared to relevant comparators to assess for significant CAD.Journal Article2022-01-09enThe Author(s)https://doi.org/10.1186/s12968-021-00833-1