PharmacoEconomics & Outcomes News 745, p12 - 30 Jan 2016 Cardiac CT cost effective in patients with chest pain Cardiac computed tomography (CT) appears to be cost effective compared with standard exercise stress testing (EST) in patients with stable chest pain, according to the findings of a cost utility analysis published in Heart. The cost effectiveness of cardiac CT was evaluated from the National Health Service perspective over a 1-year time horizon in 500 patients in Northern Ireland who were randomised to undergo cardiac CT or EST assessment in the cardiac CT for the Assessment of Pain and Plaque (CAPP) study. Cardiac CT was less costly than EST (incremental total costs –£50.45*) and more effective (incremental QALYs 0.02), and was therefore the dominant strategy. At a willingness-to-pay threshold of £20 000 per QALY, there was 83% probability that cardiac CT was cost effective. Cardiac CT appeared to be most cost effective in patients with the lowest risk (<30%) of coronary artery disease. "The lower cost observed in the cardiac CT arm is noteworthy considering that it is more expensive than EST. This additional cost was offset by a greater number of EST patients requiring further expensive investigations," said the authors. "This finding could have major implications for how patients with chest pain in the UK are assessed, however it would need to be validated in other healthcare systems," they commented. * 2010/2011 British pounds Agus AM, et al. The cost-effectiveness of cardiac computed tomography for patients with stable chest pain. Heart : 14 Jan 2016. Available from: URL: http:// 803166417 doi.org/10.1136/heartjnl-2015-308247

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PharmacoEconomics & Outcomes News 30 Jan 2016 No. 745

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