Budget Impact Analysis of Midline, Short Peripheral and, PICC Catheters for Peripheral Intravenous Infusions

OBJECTIVES: Midline catheters, despite their higher costs, are occasionally used for patients needing peripheral IV infusions. However, their economic impact relative to short peripheral cannulas (SPCs) and peripherally inserted central catheters (PICCs) has not been fully assessed. The aim of this study is to assess the budgetary impact of these three types of catheter over periods of 7, 14 and 21 days.

METHODS: A detailed micro-costing study identified the resources used during catheter care procedures, including consumables, medical and nursing care and examinations. The costs associated with complications stemming from catheter placement were derived from the French national cost study. Additionally, success rate of catheter insertion and complication frequencies were obtained from a literature review.

RESULTS: Midline catheters were found to be less costly than SPCs (savings of €39 over 7 days and €174 over 14 days) and PICCs (savings of €102 over 14 days and €95 over 21 days). Despite their higher acquisition cost, the overall cost of using midlines was lower due to reduced complications and fewer insertions.

CONCLUSIONS: The study emphasizes that while economic considerations should not be the sole factor in choosing a medical device, they are significant, especially in a strained economic environment. This analysis was conducted in a center using fluoroscopy for PICC placement, which is more costly than the more commonly used ECG-guided placement methods. However, ECG-guided placements, which are less costly, also favor midlines. Future studies should generalize these findings across various hospitals and consider quality of life impacts.