สำนักงานกองทุนสนับสนุนการสร้างเสริมสุขภาพ, สำนักงานพัฒนานโยบายสุขภาพระหว่างประเทศ,สถาบันวิจัยระบบสาธารณสุข,สำนักนโยบายและยุทธศาสตร์ กระทรวงสาธารณสุข

Objectives: This study aims to assess appropriate clinical indications for and cost of Positron Emission Tomography/Computed Tomography (PET/CT) under the Thai setting. It also estimates the potential need and supply of PET/CT within the next five years. Methods: a systematic review and meta-analysis of literature published in PubMed database were used to identify whether and which medical conditions that PET/CT was superior to other alternative technology. Micro-costing technique was used to estimate the unit cost and cost function of PET/CT at Siriraj hospital. Lastly, number PET/CT scanners, epidemiology of cancer in Thailand and relevant human resources were estimated to guide the future investment on PET/CT in Thailand. Results: Based on the current evidence PET/CT was superior to alternatives for diagnostic of cervical, colon, esophageal, lymphomas, malignant, non-small cell lung, ovarian and thyroid cancer. However, the superiority was only determined by a higher accuracy rate because there was a lack of evidence on the long-term implications i.e. the change of clinical practices, morbidity and mortality from the use of PET/CT compared to its alternatives. The largest cost component was the capital investment of the machine following with radiopharmaceuticals. At the current price of 60,000 Baht per scan, break-even point was at eight cases per week. It can be seen from the epidemiological profiles that the current number of PET/CT is sufficient for providing services to the Thai cancer patients indicated by proposed indications of eight cancers above. The other barrier of diffusion of PET/CT over country is the lack of human resources who have skills operating PET/CT. It can be considered that referring patients to perform PET/CT in Bangkok is more cost-effective than investing the new PET/CT centre outside Bangkok. Conclusions: A better policy for diffusion and use of PET/CT in Thailand can be formulated using the evidence generated from this study. It also illustrates a gap of knowledge that requires for future assessment of other diagnostic technology.