CardiacMR Cost Calculater

Description of the "CardiacMR Cost Calculator":

NEW !!  

Calculate the costs of various CAD management strategies for your health care system

Introduction and Background
Coronary artery disease (CAD) is a major contributor to  the public health burden, particularly in industrialized countries (1). In the European Union, CAD management accounted for approximately 60 billion Euros in 2009, of which about a third was attributed to direct health care costs (2). In the United States, the total direct costs of CAD were estimated to reach 107 billion dollars in the same time period (3).
CMR is now well established as a reliable and safe technique to evaluate ischemia in patients with known or suspected CAD (4-9) and it is recommended as a class I or IIa test in European and US guidelines for stable CAD, respectively (10-13).

Current Evidence - Health Care Costs for the Management of CAD
Cost analyses are increasingly published and demonstrate the potential of CMR to reduce costs in the work-up of CAD patients (14-16). However, these analyses are typically focusing on either large European countries like Germany or the United Kingdom or on the United States health care system. Currently, other countries cannot easily adapt these evaluations to their specific health care systems. E.g. a recent study compared the costs of a CMR-based strategy to detect CAD vs two invasive strategies using invasive x-ray coronary angiography alone (CXA-only strategy) or in combination with fractional flow reserve testing (CXA+FFR). In the CMR-based strategy, only patients with ischemia on CMR were scheduled for further invasive CXA and revascularization in case of coronary stenoses (CMR+CXA strategy) (17).
The CMR+CXA strategy reduced costs in comparison to the CXA+FFR strategy of 34%, 27%, 14% in the UK, Switzerland, and Germany, respectively, and by 24% in the US. Cost reductions vs the CXA-only strategy ranged from 52% to 71%, mainly driven by a higher rate of revascularizations in the strategies without ischemia testing.
See full text for free: Cost Evaluation article
These calculations are based on the diagnostic performance of CMR observed in the European CMR registry and included 3’647 patients (recruited from 59 centers in 18 European countries (18)). The analysis includes costs for the diagnostic tests, for revascularizations (PCI or CABG), and the costs for treatment of complications. For the cost calculations of the 3 strategies, the complications occurring during the first year of the CMR+CXA arm are used.

Interested to know the costs of these 3 strategies in your own health care system?  Please, follow the instructions below on how to use the “CardiacMR Cost Calculator”

The Input:
1). Enter your contact data
2). Enter the costs of the various tests and procedures into the respective fields (costs are those of the third payer perspective, e.g. based on tariffs established by the governments or insurance companies).
3). Enter the sources from where the costs were derived (tariff positions with URL addresses, date when site(s) were accessed)
4). Send the data by clicking on the “send” button

The Output:
1). Within 10 days, you will receive the results (costs and cost savings from the third payer perspecgive) by email.
2). In case of undefined costs or other uncertainties, the publisher of the website will contact you for clarification.

The Conditions:
1). The service called “CardiacMR Cost Calculator” provided by the publisher of this website is free of charge.

2). A major goal of this initiative is to allow a broader community to benefit from the model calculations published recently,17 that are based on the CMR performance of the large EuroCMR registry 18 Accordingly, the calculations are identical to those having generated the results published in the paper “Cost-minimization analysis of three decision strategies for cardiac revascularization: Results of the “suspected CAD” cohort of the European Cardiovascular Magnetic Resonance Registry”.17 The user of the “CardiacMR Cost Calculator” agrees that the data he is submitting via this website and the results calculated thereof, can be used by the publisher of the website for scientific publications. If his data are incorporated into scientific publications, he might be invited to co-author such publications.

3) The user of the “CardiacMR Cost Calculator” is free to publish the results generated by the “Cost calculator” by citing the source as: “Results generated by the “CardiacMR Cost Calculator” accessed on the website “Herz-MRI”. The model is based on conditions as described in “K. Moschetti et al. J Cardiovasc Magn Reson, 2016 (doi:10.1186/s12968-015-0222-1)".

4). The publisher of this website is not responsible (as a matter of product liability, negligence or otherwise) for any injury resulting from any result provided to the user of the “CardiacMR Cost Calculator”. The results provided should not be used for decision making without considering the full spectrum of all economical aspects influencing costs, quality, safety, and adherence to guidelines of CAD management.

5). The publisher of this website is not responsible for the correctness of calculations.

6). The publisher of this website takes no obligation to respond to the query of the “CardiacMR Cost Calculator” users.

- Publisher of this website: Juerg Schwitter, MD, Switzerland
- This service of cost calculations is a service provided solely by the publisher of this website and his collaborators. There is no affiliation with other organisations like the SCMR (Society of Cardiovascular Magentic Resonance) or any other societies that may link to this website.
- For the cost calculations we are asking for cost data from the 3rd payer perspective, i.e. from the insurance companies’ perspective, which are in the public domain (e.g. via DRG codes etc). In case of sensitive and/or confidential data on costs (that should not become public), please, do NOT transfer such data via this website. The publisher of this website takes no liability or responsibility for protection of such data during data transmission via this website, for the safe storage of such data after transfer, nor for any damages that could arise from dissemination of such data to others. In case of sensitive and/or confidential data to transfer, please, contact us via the free-text space below  (WITHOUT including any cost data) to discuss, how to proceed in such a case.
If you have any Question(s) or Comment(s) before filling in the form below - Send them now

CardiacMR Cost Calculator -- To fill in costs as of the health care payer perspective ( = tariffs of procedures)

To read the original article of K. Mochetti et al, JCMR; 2016 "Cost-minimization analysis of three decision strategies for cardiac revascularization: results of the "suspected CAD" cohort of the european cardiovascular magnetic resonance registry." open access (no charge):

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2. Leal J, Luengo-Fernandez R and Gray A. European Cardiovascular Disease Statistics. 2012.

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4.      Schwitter J, Nanz D, Kneifel S, Bertschinger K, Buchi M, Knusel PR, Marincek B, Luescher TF and von Schulthess GK. Assessment of myocardial perfusion in coronary artery disease by magnetic resonance: a comparison with positron emission tomography and coronary angiography. Circulation. 2001;103:2230-5.

5.      Nagel E, Klein C, Paetsch I, Hettwer S, Schnackenburg B, Wegscheider K and Fleck E. Magnetic Resonance Perfusion Measurements for the Noninvasive Detection of Coronary Artery Disease. Circulation. 2003;108:432-437.

6.      Schwitter J, Wacker CM, van Rossum AC, Lombardi M, Al-Saadi N, Ahlstrom H, Dill T, Larsson HBW, Flamm SD, Marquardt M and Johansson L. MR-IMPACT: Magnetic Resonance Imaging for Myocardial Perfusion Assessment in Coronary Artery Disease Trial: Comparison of perfusion CMR with Single Photon Emission Computed Tomography for the Detection of Coronary Artery Disease in a Multicenter, Multivendor, Randomized Trial. Eur Heart J. 2008;29:480-489.

7.      Schwitter J, Wacker CM, Wilke N, Al-Saadi N, Sauer E, Huettle K, Schönberg SO, Debl K, Strohm O, Ahlstrom H, Dill T, Hoebel N and Simor T. Superior diagnostic performance of perfusion-CMR versus SPECT to detect coronary artery disease: The secondary endpoints of the multicenter multivendor MR-IMPACT II. J Cardiovasc Magn Reson. 2012;14:61-71.

8.      Greenwood JP, Maredia N, Younger JF, Brown JM, Nixon J, Everett CC, Bijsterveld P, Ridgway JP, Radjenovic A, Dickinson CJ, Ball SG and Plein S. Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CE-MARC): a prospective trial. Lancet. 2012;379:453-60.

9.      Plein S, Schwitter J, Suerder D, Greenwood JP, Boesiger P and Kozerke S. k-Space and time sensitivity encoding-accelerated myocardial perfusion MR imaging at 3.0 T: comparison with 1.5 T. Radiology. 2008;249:493-500.

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11.   McMurray JJV, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Sanchez MAG, Jaarsma T, Køber L, Lip GYH, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rønnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F and Zeiher A. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur Heart J. 2012:1787–1847.

12.   Windecker S, Kolh P, Alfonso F, Collet J-P, Cremer J, Falk V, Filippatos G, Hamm C, Head SJ, Jüni P, Kappetein AP, Kastrati A, Knuuti J, Landmesser U, Laufer G, Neumann F-J, Richter DJ, Schauerte P, Sousa Uva M, Stefanini GG, Taggart DP, Torracca L, Valgimigli M, Wijns W and Witkowski A. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2014.

13.   Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King Iii SB, Kligfield PD, Krumholz HM, Kwong RYK, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith Jr CR, Smith Jr SC, Spertus JA and Williams SV. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease: A Report of the ACC Foundation/AHA Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2012;60:e44-e164.

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15.   Moschetti K, Favre D, Pinget C, Pilz G, Petersen SE, Wagner A, Wasserfallen JB and Schwitter J. Comparative cost-effectiveness analyses of cardiovascular magnetic resonance and coronary angiography combined with fractional flow reserve for the diagnosis of coronary artery disease. J Cardiovasc Magn Reson. 2014;16:13.

16.   Moschetti K, Muzzarelli S, Pinget C, Wagner A, Pilz G, Wasserfallen JB, Schulz-Menger J, Nothnagel D, Dill T, Frank H, Lombardi M, Bruder O, Mahrholdt H and Schwitter J. Cost evaluation of cardiovascular magnetic resonance versus coronary angiography for the diagnostic work-up of coronary artery disease: application of the European Cardiovascular Magnetic Resonance registry data to the German, United Kingdom, Swiss, and United States health care systems. J Cardiovasc Magn Reson. 2012;14:35.

17.   Moschetti K, Petersen S, Pilz G, Kwong R, Wasserfallen J-B, Lombardi M, Korosoglou G, Van Rossum A, Bruder O, Mahrholdt H and Schwitter J. Cost-minimization analysis of three decision strategies for cardiac revascularization: results of the "suspected CAD" cohort of the european cardiovascular magnetic resonance registry. J Cardiovasc Magn Reson. 2016;18:3. Cost Evaluation article

18.   Bruder O, Wagner A, Lombardi M, Schwitter J, van Rossum A, Pilz G, Nothnagel D, Steen H, Petersen S, Nagel E, Prasad S, Schumm J, Greulich S, Cagnolo A, Monney P, Deluigi C, Dill T, Frank H, Sabin G, Schneider S and Mahrholdt H. European cardiovascular magnetic resonance (EuroCMR) registry - multi national results from 57 centers in 15 countries. J Cardiovasc Magn Reson. 2013;15:9.

The content of this website is copyright protected. Copyright ©, 2016, J. Schwitter, MD, FESC
Read the Cost Evaluation article !
K. Moschetti et al. J. Cardiovasc. Magn. Reson. 2012,14;35.