Cost-effectiveness of pediatric central venous catheters in the UK: A secondary publication from the CATCH clinical trial


Ridyard, CH, Plumpton, CO, Gilbert, RE, Hughes, DA ORCID: 0000-0001-8247-7459, Gamble, C ORCID: 0000-0002-3021-1955, Dwan, K, Moitt, T, Breen, R, Wade, A, Mok, Q et al (show 11 more authors) (2017) Cost-effectiveness of pediatric central venous catheters in the UK: A secondary publication from the CATCH clinical trial Frontiers in Pharmacology, 8 (SEP). 644-. ISSN 1663-9812, 1663-9812

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Abstract

Background: Antibiotic-impregnated central venous catheters (CVCs) reduce the risk of bloodstream infections (BSIs) in patients treated in pediatric intensive care units (PICUs). However, it is unclear if they are cost-effective from the perspective of the National Health Service (NHS) in the UK. Methods: Economic evaluation alongside the CATCH trial (ISRCTN34884569) to estimate the incremental cost effectiveness ratio (ICER) of antibiotic-impregnated (rifampicin and minocycline), heparin-bonded and standard polyurethane CVCs. The 6-month costs of CVCs and hospital admissions and visits were determined from administrative hospital data and case report forms. Results: BSIs were detected in 3.59% (18/502) of patients randomized to standard, 1.44% (7/486) to antibiotic and 3.42% (17/497) to heparin CVCs. Lengths of hospital stay did not differ between intervention groups. Total mean costs (95% confidence interval) were: £45,663 (£41,647-£50,009) for antibiotic, £42,065 (£38,322-£46,110) for heparin, and £44,503 (£40,619-£48,666) for standard CVCs. As heparin CVCs were not clinically effective at reducing BSI rate compared to standard CVCs, they were considered not to be cost-effective. The ICER for antibiotic vs. standard CVCs, of £54,057 per BSI avoided, was sensitive to the analytical time horizon. Conclusions: Substituting standard CVCs for antibiotic CVCs in PICUs will result in reduced occurrence of BSI but there is uncertainty as to whether this would be a cost-effective strategy for the NHS.

Item Type: Article
Uncontrolled Keywords: cost-effectiveness analysis, bloodstream infection, central venous catheter, pediatric intensive care, antibiotic, heparin
Depositing User: Symplectic Admin
Date Deposited: 15 Aug 2018 09:27
Last Modified: 28 Feb 2026 23:48
DOI: 10.3389/fphar.2017.00644
Open Access URL: https://www.frontiersin.org/articles/10.3389/fphar...
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3025049
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