Economic evaluation of single-photon emission-computed tomography versus stress echocardiography in stable chest pain patients

The timely diagnosis of coronary artery disease (CAD) is an important medical problem. This study aims to assess the cost-effectiveness of Single-Photon Emission-Computed Tomography (SPECT) compared with stress echocardiography in stable chest pain patients. An economic evaluation study was conducted to assess the cost-effectiveness of SPECT versus stress echocardiography in stable chest pain patients without known CAD between April 1, 2017, and September 1, 2018 in Tehran, Iran. This study was performed from a societal perspective. The incremental cost-effectiveness ratio was calculated using a decision tree model. In addition, the robustness of results was examined by deterministic and probabilistic sensitivity analysis. This study showed that the expected cost and expected QALY for Stress echocardiography was $1106.75 and 0.83 respectively. Also, SPECT had expected cost and expected QALY equal to $1622.39 and 0.80 respectively. Finally, Stress echocardiography was the dominant strategy for CAD, with a lower cost and greater effectiveness than SPECT. The stress echocardiography can saved $18,528.17 per QALY. A deterministic and probabilistic sensitivity analysis confirmed the robustness of the results. Stress echocardiography was a more cost-effective method for diagnosing CAD disease in stable chest pain patients without known CAD compared to SPECT.