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Background <p>Diffuse large B-cell lymphoma (DLBCL) accounts for 58% of non-Hodgkin lymphoma cases in Thailand. Positron Emission Tomography-Computed Tomography (PET-CT) offers superior accuracy for staging and assessing end-of-treatment (EOT) response than Computed Tomography (CT) and is recommended in Thai and international clinical practice guidelines. Due to its high cost, an economic evaluation and budget impact analysis were conducted to inform policy decisions.</p> Methods <p>A cost-utility analysis using a decision tree and Markov model was conducted from a societal perspective, alongside a budget impact analysis from the payer’s perspective. Parameters were derived from literature and primary data. Three policy options were compared with current practice (CT for staging and EOT): (1) PET-CT for both staging and EOT, (2) PET-CT for staging only, and (3) PET-CT for EOT only. Sensitivity and scenario analyses were also conducted.</p> Results <p>At Thailand’s cost-effectiveness threshold of 160,000 THB per quality-adjusted life year (QALY), PET-CT for EOT only was the most cost-effective option, with an incremental cost-effectiveness ratio (ICER) of 23,282 THB/QALY. PET-CT for both staging and EOT was the second most cost-effective (ICER 123,586 THB/QALY), while PET-CT for staging only was not cost-effective. Results were consistent across analyses. Budget impact over 5 years was lowest for PET-CT for EOT only (67&#xa0;million THB) and highest for PET-CT for both staging and EOT (150&#xa0;million THB).</p> Conclusion <p>Using PET-CT solely for EOT is not only the most cost-effective option but also results in the lowest budget impact. Inclusion of this option in the benefit package is recommended.</p>

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Economic evaluation of PET-CT in staging and response assessment of patients with diffuse large B-cell lymphoma (DLBCL) in Thailand: a cost-utility analysis

  • 期刊论文

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  • 发表日期：

    2026年8月4日

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  • Jarawee Sukmanee,
  • Chittawan Poonsiri,
  • Chotika Suwanpanich,
  • Panarat Noiperm,
  • Aimwipa Lueprasitsakul,
  • Nattiya Teawtrakul,
  • Lalita Norasetthada,
  • Pritaporn Kingkaew

摘要

Background

Diffuse large B-cell lymphoma (DLBCL) accounts for 58% of non-Hodgkin lymphoma cases in Thailand. Positron Emission Tomography-Computed Tomography (PET-CT) offers superior accuracy for staging and assessing end-of-treatment (EOT) response than Computed Tomography (CT) and is recommended in Thai and international clinical practice guidelines. Due to its high cost, an economic evaluation and budget impact analysis were conducted to inform policy decisions.

Methods

A cost-utility analysis using a decision tree and Markov model was conducted from a societal perspective, alongside a budget impact analysis from the payer’s perspective. Parameters were derived from literature and primary data. Three policy options were compared with current practice (CT for staging and EOT): (1) PET-CT for both staging and EOT, (2) PET-CT for staging only, and (3) PET-CT for EOT only. Sensitivity and scenario analyses were also conducted.

Results

At Thailand’s cost-effectiveness threshold of 160,000 THB per quality-adjusted life year (QALY), PET-CT for EOT only was the most cost-effective option, with an incremental cost-effectiveness ratio (ICER) of 23,282 THB/QALY. PET-CT for both staging and EOT was the second most cost-effective (ICER 123,586 THB/QALY), while PET-CT for staging only was not cost-effective. Results were consistent across analyses. Budget impact over 5 years was lowest for PET-CT for EOT only (67 million THB) and highest for PET-CT for both staging and EOT (150 million THB).

Conclusion

Using PET-CT solely for EOT is not only the most cost-effective option but also results in the lowest budget impact. Inclusion of this option in the benefit package is recommended.