Cost-Effectiveness of Pediatric Central Venous Catheters in the UK: A Secondary Publication from the CATCH Clinical Trial



Ridyard, Colin H, Plumpton, Catrin O, Gilbert, Ruth E and Hughes, Dyfrig A ORCID: 0000-0001-8247-7459
(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-.

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Abstract

<b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> 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: 19 Jan 2023 01:28
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