The economic implications of setting up a CT colonog-raphy service must also be considered. Each department must consider whether or not it is financially viable for them to provide this service. Estimates suggest that, when all factors are considered, the real cost of providing a CT colonography examination is in the order of 250 Euro. Balanced against this is the ongoing difficulty with reimbursement, which varies widely from country to country and even from state to state in North America. Apart from a handful of health care providers there is currently no reimbursement for screening CT colonography and limited and inconsistent reimbursement when the test is performed in symptomatic patients. Although many patients are willing to pay for CT colonography this is clearly not sustainable nor appropriate. Radiologists must be able to address and discuss these issues with their local health insurance companies to ensure that the interests of their patients are protected and that they are appropriately reimbursed for capital costs and their professional time.
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