Use of low-osmolality contrast media in a price-sensitive environment

Over the past 3 years, three radiographic contrast media that are lower in osmolality than traditional contrast media have become available in the United States. These lower osmolality media have been reported to produce fewer adverse reactions than the higher osmolality media, but they cost 10 to 20 times more than higher osmolality media. To explore hospital and physician decision-making regarding the use of lower osmolality media in the increasingly price-sensitive health-care environment, we surveyed the 40 hospitals in the United States that received the most funding from the National Institutes of Health in 1985. Radiologists in 27 (68%) of the hospitals responded. Of these, 93% believed lower osmolality media improve the quality of patient care. However, nearly half of responding institutions limited the use of lower osmolality media. On average, in 1986 lower osmolality media were used in 9% of procedures in which contrast media were injected intravascularly. The decision to limit use was made pri...