Cost analysis comparison between peripherally inserted central catheters and implanted chest ports in patients with cancer—A health economic evaluation of the PICCPORT trial

Research output: Contribution to journalArticle

Abstract

Background: A reliable central venous access device is a cornerstone in the treatment of cancer. Both peripherally inserted central catheters (PICC) and totally implanted chest ports (PORT) are commonly used for the delivery of chemotherapy. Both types of catheter can cause adverse events such as catheter-related deep venous thrombosis (CR-DVT), infection and mechanical complications. 

Method: We conducted a randomized controlled trial including 399 patients with cancer and performed a health economic evaluation investigating the cost related to PICCs and PORTs using several clinically relevant dimensions from a healthcare perspective. The cost was determined using process and cost estimate models. 

Result: PICCs are associated with a higher total cost when compared with PORTs. Combining the costs of all categories, the prize per inserted device was 824.58 EUR for PICC and 662.34 EUR for PORT. When adjusting for total catheter dwell time the price was 6.58 EUR/day for PICC and 3.01 EUR/day for PORT. The difference in CR-DVT was the main contributor to the difference in cost. The daily cost of PICC is approximately twice to that of PORT. 

Conclusion: We have demonstrated that the cost from a healthcare perspective is higher in cancer patients receiving a PICC than to those with a PORT. The difference is driven mainly by the cost related to the management of adverse events. Our findings are relevant to anaesthetists, oncologists and vascular access clinicians and should be considered when choosing vascular access device prior to chemotherapy.

Details

Authors
  • Knut Taxbro
  • Fredrik Hammarskjöld
  • David Juhlin
  • Helga Hagman
  • Lars Bernfort
  • Sören Berg
External organisations
  • Ryhov County Hospital, Jönköping
  • Linköping University
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Health Care Service and Management, Health Policy and Services and Health Economy
  • Surgery

Keywords

  • adverse effects, economics, neoplasm, peripherally inserted central line, vascular access device, vascular access port
Original languageEnglish
JournalActa Anaesthesiologica Scandinavica
Publication statusE-pub ahead of print - 2019 Nov 12
Publication categoryResearch
Peer-reviewedYes
Externally publishedYes