Cost–effectiveness of iodinated contrast media for CT scanning in Spain: a decision-based analysis

Background Iodinated contrast media (CM) are among the most commonly used radiocontrast agents in radiographic examinations or in MRI studies. The clinical development of non-ionic low-osmolar or iso-osmolar iodinated CM has improved both image quality and safety of radioimaging studies. Nevertheless, CM-induced adverse reactions continue to be a public health problem; they are unpredictable and diverse in nature [1]. The added therapeutic value of iodinated CM may be defined according to their comparative safety, efficacy and cost–effectiveness. The efficacy or quality of the diagnostic image of iodinated CM mainly depends on iodine delivery rate [2], but the safety profile and efficiency may vary according to the type of CM administered. Although iodinated intravascular CM have been widely used over the last decades in various imaging diagnostic techniques, including CT, few data have been published on the cost–effectiveness of the different CM. Cost–effectiveness analyses of CM used in cardiology have been recommended [3], but economic data of iodinated CM used in radiodiagnostics are, in general, lacking [4]. In this context, we conducted a decision-based analysis to examine the cost–effectiveness of lowand iso-osmolar iodinated CM in adult patients undergoing CT in Spain.