Analisi di impatto sul budget dell’impiego della medicazione antimicrobica Tegaderm™ CHG rispetto ad una medicazione standard nel contesto delle terapie intensive in Italia
Francesco Venneri, Giovanna Barbera, Lucilla Nozzoli, Claudio Pelucchi, Carlotta Galeone
Introduction Healthcare-Associated Infections (HAI) are a major public health problem, but many of them are avoidable by prevention and control programmes. To date, there are several medical devices useful in HAI prevention. We conducted a budget impact analysis (BIA) to evaluate the impact of the use of an antimicrobial dressing, Tegaderm CHG, for prevention of vascular access infections, as compared to a standard dressing, from the Italian Healthcare Service perspective.
Materials and Methods Baseline risk estimates of catheter related bloodstream infections (CRBSI) and exit-site infections were based on Italian Infection Surveillance Programmes, while contact dermatitis risk was estimated from published data. The corresponding risks associated to the use of the antimicrobial dressing were based on effectiveness results of a randomised clinical trial. Resource utilization was estimated from published data or collected through available regional tariffs. Only direct medical costs were considered.
Results The BIA estimated financial consequences associated to an increased use of antimicrobial dressings in Intensive care units, under two scenarios: Tegaderm CHG used in 70% and 100% of cases. The major cost driver associated to catheter related infection is the treatment of CRBSI. Under the 100% use scenario, it was estimated a reduction in the number of CRSBI from about 3,000 to about 1,200 and a corresponding resource savings on total annual costs in Italy of about 17.4 million euro. This is partly offset by the increased wound dressing costs; thus, final total savings amount to 13.7 million euro.
Conclusions HAI are in many cases preventable by adequate control programmes. Considering only one of several possible strategies, i.e. the increased use of antimicrobial dressings, the Italian Healthcare System can obtain a relevant reduction in the number of infections and therefore attain considerable savings.
Key words: Budget Impact Analysis, central venous catheter, medical device, associated catheter infection, hospital infections, intensive care