PSMA-PET scan cost why?

Hello Sprinter .

As you say, the technology and staff are in place to administer it. My thoughts are that the difficulty is the availability of the tracer which has to be specially prepared for each patient based on their weight and only a limited number of places have the capability to do this at the moment. Also it has a short shelf life so they cannot produce it on a batch basis. Reading and interpretation of the results needs training in order to minimise over treatment due to false positives which are becoming more apparent as they get a better understanding of the technology. 

Hi Sprinter that’s a very good question and I will attempt to answer it.  You are quite right that effectively it is completely free once the machine is in situ and the staff are recruited and trained.  However, in order to understand the cost in relation to other treatments, an attempt is made (with all treatments) to devise a relative cost.  If you look at the price of a new scanner around £10m say and then it is used by 4000 patients in its life, the machine cost would be £2,500 per go.  Obviously, you can play about with the figures and getting 8,000 patients would halve the nominal cost but you hopefully see that the hardware is likely to be a major part of the cost.  In addition, the wages are obviously not free and nor is training on new equipment, possibly building costs, and even down to electricity, plus the isotope production as AH has mentioned.  Private companies will obviously factor in a profit factor as well, so you can see how it all adds up.  I am sure there are others who can explain the Cost Accounting process much better than my ramblings, but hope that helped.  David

As for paying for it

this is totally down to either

1.not being prepared to wait until the NHS can provide an appointment or 

2. Wishing to have it whilst the NHS does not consider it to be required or not cost effective 

Hi Alwayshope

Thanks for your reply, I appreciate that there is a cost for the tracer, however Genesis Care prices for the scan start at £2500, so I'd be surprised if the tracer cost was a significant part of that figure, as the cost of the equipment etc has to be recouped along with them making a profit.

I wasn't aware that the tracer had a short shelf life and expected it to be a standard nuclear medicine as used in other scans, with the dosage being calculated simply by the weight of the patient and also expected it to be more or less an off the shelf product 

It's all interesting stuff and being bored just trying to understand why some say it is possibly rationed due to cost

Regards 

Sprinter 

Hi David 

Thanks for your reply.

I agree that the cost will be averaged out over the life expectancy of the equipment and therefore the number of scans performed. However having purchased the equipment it's seems odd that people quote the cost as a potential reason as to why it is difficult to have a scan performed. My view is once you've made the decision to purchase and it's installed with training etc done, then use it to its full potential. But as we know the NHS works in mysterious ways.

I'm just bored as decided it doesn't really make sense to go driving through Europe with business until my 6th cycle of Docetaxel is over early November, so probably more like December when hopefully the more annoying side effects have disappeared, hence doing a lot of reading not just about PC and this topic intrigued me.

Regards

Sprinter 

Hi !

I would guess that PSMA Pet scans are just used to the max like ours in Sweden but the criterias are stated high i suppose like high gleason score, PSA levels of > 10 and upwards and  probably at least a T3 staging with high risk of spread.

But I suppose there are private clinic offering PSMA Pet Scan but you have to from your own pocket.

Best wishes - Ulf

I paid for my MRI privately as I wanted to check my prostate despite having very low PSA. Thank god I did as a tumour was found contained within my prostate. 

Do not rely on PSA results (very hit and miss in my experience) and if you can do so, pay privately for peace of mind.

Hi Paulo

I agree never rely entirely on PSA , apparently came about for testing after treatment.

Often it's ok as a first indicator that something is wrong but some prostate cancers have a low secreting PSA so then obviously you're in the dark and don't know what's going on.

Best wishes 

Steve 

 Sprinter I would hope that the machines are used to capacity and you are correct that cost shouldn’t be a factor until near 100% occupancy. But once capacity is reached, then the ‘cost’ per patient can be calculated and is a factor in determining if another machine should be bought.  The success of the NHS in keeping us alive works against it.  In my own case, I have just gone onto Enzalutamide which costs about £100 per day (hopefully the NHS is paying that much!).  Ten years ago they wouldn’t have had that expense because I would have been dead. David

Hi David

Yes that's very true, keeping us alive is expensive, I'm on Darolutimide and the published cost before NHS discount is £144 a day. So glad that I don't have to pay for everything as with all the other drugs required it's a scary amount.