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Cost-effectiveness of 123I-FP-CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy


  • Potential conflict of interest: The study was funded by an unrestricted grant from GE Healthcare (formerly Amersham Health) to PBE consulting, Verona, Italy (Berto and Lopatriello). At the time of the study Michael Chambers was an employee of GE Healthcare. Lieven Annemans received an unrestricted grant from GE healthcare for the development of the original model. Angelo Antonini and Filippo Tamma have received consultancy fees from GE Healthcare.


Economic evaluation (Italian NHS perspective) modeling 123I-FP-CIT SPECT (DaTSCAN®) compared to clinical judgment alone for differentiating essential tremor (ET) from Parkinson's Disease (PD). A 5-year Markov model was constructed to assess the cost-effectiveness of 123I-FP-CIT SPECT to differentiate ET from PD in patients referred to a movement disorder specialist in Italy. Published data and a double-round, Delphi panel of 12 specialists populated the model. Effectiveness was expressed as the projected Years on potentially beneficial therapy (PBTYs). Costs were expressed in Euros (2005 values). The model suggests that over 5 years, the “current” diagnostic pathway generated an average of 2.3 PBTYs/patient at an estimated cost of €8,864. 123I-FP-CIT SPECT generated an average of 4.1 PBTYs/patient at an estimated cost of €8,422, which represented an additional 1.8 PBTYs at a cost saving of €442/patient (€341 when discounted at 5%). The estimated cost-effectiveness of 123I-FP-CIT SPECT is under €1,000 per PBTY gained when the underlying disease prevalence is high (55–70%), and cost-saving at prevalence under 55%. 123I-FP-CIT SPECT is likely to be regarded as economically advantageous to differentiate ET from PD, increasing time on potentially beneficial therapy at a lower overall cost to the healthcare system. © 2008 Movement Disorder Society