PET FDG *** (cost-effectiveness) FDG-PET (fluorodeoxyglucose-positron emission tomography) PET PET PET/PET-CT PET PET FDG PET FDG PET PET PET

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1 119 PET FDG * *, ** * * *** PET 10 PET 2005 FDG PET FDG FDG 3 PET PET FDG A B C 3 PET 1,591 1, , , ,192 2,583 2,679 2,081 FDG PET PET PET PET ( 45: , 2008) FDG-PET (fluorodeoxyglucose-positron emission tomography) 10 PET 1,2) * 22 ** *** ( ) 22 PET (cost-effectiveness) 3,4) PET 5) PET FDG FDG PET PET FDG 75 (PET PET-CT PET/PET-CT

2 (2008 ) ) 6) FDG 3 5 7) FDG FDG FDG FDG FDG 2007 FDG (46,000 ) PET (75,000 ) 61.3% PET/CT (86,250 ) 53.3% FDG FDG FDG PET Berger 8) FDG (1) FDG PET (2) FDG 2 (1) ( ) 4 4, 6 3 A 200 B 500, C PET/CT (2) PET PET PET (fixed cost) (variable cost) ( ) (3) PET (annual total cost) 1 (cost per scan) PET/ CT (86,250 ) (1) PET PET A 1,591 ( ) B 1,637 (1, ) C

3 PET FDG 121 Table 1 Cost analysis of three PET facilities that utilize delivery FDG Facility A Facility B Facility C Annual cost Cost per scan Annual cost Cost per scan Annual cost Cost per scan (1,000 yen) (yen) (1,000 yen) (yen) (1,000 yen) (yen) Fixed Costs 99,478 62, ,577 63,883 78,131 85,482 Construction 9,974 6,269 6,441 3,935 16,858 18,444 Equipment (PET scanner and others) 38,052 23,917 60,653 37,051 32,713 35,790 Personnel 40,006 25,145 37,483 22,897 16,380 17,921 Physicians 18,409 11,571 16,143 9,861 3,650 3,993 Non-physicians 21,597 13,574 21,340 13,036 12,730 13,928 Maintenance 11,446 7, ,180 13,326 Variable Costs Supplies 74,149 46,605 77,029 47,055 42,874 46,908 Miscellaneous 1,800 1, ,647 1,802 Total 175, , , , , ,192 Fig. 1 The break-even point analysis of three facilities. 914 ( ) PET (2) Table 1 A 9,948 B C 7,813 C A, B 4,001 3,748 C 1,638 A, B, C 1 110,262 B 111,091 C 134,192 C 1

4 (2008 ) Fig. 1 A, B, C 2,583 2,679 2,081 PET ) FDG ,000 FDG PET FDG FDG FDG ( ) 8) PET 3 FDG 3 PET PET PET PET PET 9,10) 11,12) PET 1) Juweid ME, Cheson BD: Positron-emission tomography and assessment of cancer therapy. N Engl J Med 2006; 354: ) van Tinteren H, Hoekstra OS, Smit EF, van den Bergh JH, Schreurs AJ, Stallaert RA, et al: Effectiveness of positron emission tomography in the preoperative assessment of patients with suspected non-small-cell lung cancer: the PLUS multicentre randomised trial. Lancet 2002; 359: ) Yap KK, Yap KS, Byrne AJ, Berlangieri SU, Poon A, Mitchell P, et al: Positron emission tomography with selected mediastinoscopy compared to routine mediastinoscopy offers cost and clinical outcome benefits for pre-operative staging of non-small cell lung cancer. Eur J Nucl Med Mol Imaging 2005; 32: ) Verboom P, van Tinteren H, Hoekstra OS, Smit EF, van den Bergh JH, Schreurs AJ, et al: Cost-effectiveness of FDG-PET in staging non-small cell lung cancer: the PLUS study. Eur J Nucl Med Mol Imaging 2003; 30: ) Yasuda S, Ide M: PET and cancer screening. Ann Nucl Med 2005; 19: ) PET PET/CT. 2007; 34 (1): ) : PET ;

5 PET FDG (2): ) Berger M, Gould MK, Barnett PG: The cost of positron emission tomography in six United States Veterans Affairs hospitals and two academic medical centers. AJR Am J Roentgenol 2003; 181 (2): ) : ) : ) PET ) Summary Business Administration of PET Facilities: A Cost Analysis of Three Facilities Utilizing Delivery FDG Naohiro MITSUTAKE*, Shinya OKU*, **, Ryo FUJII*, Yuji FURUI* and Hideo YASUNAGA*** *Healthcare Related Informatics, 22nd Century Medical and Research Center, The University of Tokyo Hospital **Department of Radiology, Saitama Medical Center ***Department of Health Management & Policy, Graduate School of Medicine, The University of Tokyo Background: PET (positron emission tomography) has been proved to be a powerful imaging tool in clinical oncology. The number of PET facilities in Japan has remarkably increased over the last decade. Furthermore, the approval of delivery FDG in 2005 resulted in a tremendous expansion of the PET institutions without a cyclotron facility. The aim of this study was to conduct a cost analysis of PET institutions that utilized delivery FDG. Methods: Three PET facilities using delivery FDG were investigated about the costs for PET service. Fixed costs included depreciation costs for construction and medical equipments such as positron camera. Variable costs consisted of costs for medical materials including delivery FDG. The break-even point was analyzed in each of three institutions. Results: In the three hospitals (A, B and C), the annual number of PET scan was 1,591, 1,637 and 914, while cost per scan was accounted as 110,262, 111,091, and 134,192, respectively. The break-even point was calculated to be 2,583, 2,679 and 2,081, respectively. Conclusions: PET facilities utilizing delivery FDG seemed to have difficulty in business administration. Such a situation suggests the possibility that the current supply of PET facilities might exceed actual demand for the service. The efficiency of resource allocation should be taken into consideration in the future health service researches on PET. Key words: Positron emission tomography, Cost analysis, Cancer screening.

Setting The setting was a hospital. The economic study was carried out in Australia.

Setting The setting was a hospital. The economic study was carried out in Australia. Positron emission tomography with selected mediastinoscopy compared to routine mediastinoscopy offers cost and clinical outcome benefits for pre-operative staging of nonsmall cell lung cancer Yap K K,