Un esempio di Budget Impact Analysis sulla scelta del dispositivo
per accesso venoso centrale (PICC vs PORT): il ruolo del farmacista ospedaliero
Ada Iezzi, Emanuela Omodeo Salè
Background In recent years, technological progress has led to the implementation and development of new central peripherally inserted central catheter systems (PICCs) and implanted port (PORTs) to improve patient safety and patient's quality of life (QoL). The economic impact of these innovations, considering the volumes of use in clinical practice, is important even for potential complications. Our aim was to understand the characteristics of the setting of the two medical device and the possible consequences on the budget of their use.
A budget impact analysis (BIA) was conducted.
Results and discussion The number of PICCs placed in 2015 was 370 for a cost charge of € 88,560.00; 491 in 2016 for a cost of € 116,880.00 and 649 in 2017 for a cost of € 144,960.00. The number of PORTs placed in 2015 was 547 for a cost of € 75,804.80; 519 in 2016 for a cost of € 75,029.70 and 482 in 2017 for a cost of € 69,839.20. Estimated cost per hospital patient per placement of the PICC and PORT systems respectively was approximately € 458.74 for PICCs Groshong, € 434.74 for Power PICCs and € 642.31 for PORT. There is currently no regional reimbursement rate for services rendered under ordinary hospital and day hospital care. Device placement falls within the MAC performance packet (MAC 11 for the PORT plant, MAC 01 02 03 for the PICC plant) depending on the type of chemotherapy associated with the decision No. IX/2946 of the Lombardy Region.
Conclusion In order to prevent complications, the appropriate venous access device should be chosen. The BIA has enabled us to estimate that, to date, the cost of the PICC is less compared with PORT but this placement hasn’t regional reimbursement. Information relating to complications and patient’s QoL is still limited in the literature for this medical device.
Key words: medical devices, central venous access, innovation, Budget Impact Analysis, reimbursement, hospital pharmacist