TBA (25W143)

Intestinal Ultrasound is a Cost-effective Method of IBD Assessment

Author(s)

McCrossan M, McDonnell E, McGettigan N, Iqbal N, Ryan J, Cheriyan D, Boland K, O’Toole A and Rowan C.

Department(s)/Institutions

Department of Gastroenterology, Beaumont Hospital, Dublin.

Introduction

Intestinal Ultrasound (IUS) is a non-invasive, point-of-care method of assessing inflammatory bowel disease (IBD). IUS is an established alternative to conventional modalities such as MRI.

Aims/Background

To assess the cost effectiveness of IUS compared with conventional methods of IBD assessment.

Method

We used a costing model developed by Takeda Ireland, designed to compare costs of IUS and established assessment modalities. This model operates on the premise that IUS has similar sensitivity and specificity to magnetic resonance enterography (MRE) and endoscopy in appropriately selected patients. Separate pathways for IUS and MRE were mapped in the model and validated by two Irish gastroenterologists. We populated these pathways with relevant data from our centre to perform a cost comparison. Costs associated with IUS included operator costs, IUS machine costs, and servicing/PACS costs. Costs associated with MRE included triage, scan costs and radiologist reporting cost.

Results

IUS costs €352.31 per patient, which compares favourably with MRE (€755.92) and colonoscopy (€1001). Prior local audit data highlighted 85% of patients referred for MRE are suitable for IUS, saving €34307 per 100 patients. 65% of IBD endoscopy referrals could be assessed by IUS, saving €42164 per 100 patients. ~400 IUS scans are performed annually in our centre, with potential savings of €137,000/annum (per operator).

Conclusions

IUS is a cost-effective and accurate modality. Investment in training and equipment to reach the full potential of IUS will improve patient access to rapid therapeutic decision-making and allow re-allocation of radiology and endoscopy resources.