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.
6 affiliations
- 1Health Intervention and Technology Assessment Program Foundation (HITAP), Ministry of Public Health, 6th floor, 6th building, Nonthaburi, Thailand.
- 2Health Intervention and Technology Assessment Program Foundation (HITAP), Ministry of Public Health, 6th floor, 6th building, Nonthaburi, Thailand. [email protected].
- 3Hematology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
- 4Hematology and Cell Therapy Unit, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
- 5Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
- 6Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Abstract
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.
Related
- Economic evaluation of SGLT2 inhibitors and GLP-1 receptor agonists in Thai patients with type 2 diabetes and established atherosclerotic cardiovascular disease
- Impact of body composition on toxicity and response in patients with advanced-stage Hodgkin lymphoma treated with BV-AVD
- Improving the detection, assessment, management and prevention of delirium in palliative care units (the DAMPen-Delirium II study): protocol for an implementation-to-target Type III hybrid effectiveness-implementation cluster randomised-controlled trial, economic evaluation and process evaluation of the Creating Learning Environments for Compassionate Care-Palliative (CLECC-Pal) implementation strategy.
- Pretreatment Prognostic Nutritional Index Is Associated with Treatment Response and Survival in Patients with Relapsed or Refractory Non-Hodgkin Lymphoma Receiving CAR-T Cell Therapy
- Development and Population-Based Prognostic Utility Assessment of an ICD-10-CM-Based Prediction Model to Identify Left Ventricular Systolic Dysfunction: Discrimination Performance and Population-Based Evaluation in 83,357 Patients with Acute Coronary Syndrome
BibTeX
@article{sukmanee2026economic,
title = {{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.}},
author = {Jarawee Sukmanee and Chittawan Poonsiri and Chotika Suwanpanich and Panarat Noiperm and Aimwipa Lueprasitsakul and Nattiya Teawtrakul and Lalita Norasetthada and Pritaporn Kingkaew},
journal = {Cost effectiveness and resource allocation : C/E},
year = {2026},
month = aug,
doi = {10.1186/s12962-026-00807-z},
url = {https://europepmc.org/article/MED/42958392},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - 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.
AU - Jarawee Sukmanee
AU - Chittawan Poonsiri
AU - Chotika Suwanpanich
AU - Panarat Noiperm
AU - Aimwipa Lueprasitsakul
AU - Nattiya Teawtrakul
AU - Lalita Norasetthada
AU - Pritaporn Kingkaew
PY - 2026
DA - 2026/08/04
JO - Cost effectiveness and resource allocation : C/E
DO - 10.1186/s12962-026-00807-z
UR - https://europepmc.org/article/MED/42958392
AB - 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.
SN - 1478-7547
ER -