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KMID : 1146320210090010058
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Journal of Health Technology Assessment
2021 Volume.9 No. 1 p.58 ~ p.64
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Cost-Minimization Analysis of Midline Catheters versus Peripherally Inserted Central Catheters in Korea
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Gala Smeet
Shim Ha-Na
Jeon Sook-Young
Euh Yoon-Je
Lee Kwon-Sun
Kwon Kyung-Woo
Bae Sung-Yoon
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Abstract
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Objectives: Due to the lack of an appropriate alternative vascular access device, peripherally inserted central catheter (PICCs) are used unnecessarily among patients who do not require longterm catheterization. Unnecessary use of PICCs can lead to catheter-related blood stream infections (CRBSIs) or other complications that pose a substantial clinical and economic burden on patients and healthcare systems. Introduction of midline catheters (MCs) provides a cost-saving option for patients who require mid-term catheterization. This study investigated the cost-difference of using MCs vs. PICCs following the inclusion of MCs on a reimbursement list in Korea.
Methods: A costminimization analysis conducted from the healthcare system perspective compared the costs of device use, complications, and labor for MCs and PICCs in a Korean inpatient setting over a year. Clinical and cost inputs were obtained from literature searches and the Health Insurance Review and Assessment (HIRA) Service database. The base case assumed that MCs were not reimbursed and thus all patients received PICCs. The future scenario predicted total costs when MCs were reimbursed, leading to an increased use of MCs in clinical practice. Sensitivity analyses were conducted to identify key drivers of cost savings. Scenario analyses assessed cost savings when the estimated percentage of patients using MCs was altered in the model.
Results: Introduction of MCs led to cost savings of KRW 9,374,456,648 over a year, attributed to lower device costs, lower rates of CRBSI, and shorter insertion time associated with MCs compared with PICCs. The mean duration of PICC insertion time, annual mean salary of healthcare professionals performing PICC insertions, and prevalence of CRBSI for PICCs were key drivers of cost savings. Cost savings were still observed when the percentage of patients receiving MCs was as low as 10% in the model.
Conclusion: The availability of MCs presents a cost-saving option to patients who were receiving unnecessary PICCs for mid-term catheterization during hospitalization in Korea.
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KEYWORD
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Catheter-related blood stream infection, Cost-minimization analysis, economic burden, Midline catheters, Mid-term catheterization, Peripherally inserted central catheters, Vascular access devices
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