PICC Line (PICC) or Central Inserted Venous Catheter (CICC ) in Cancer Patients: Comparative Effectiveness and Cost-Effectiveness Analysis in Brasil/LATAM/LMIC
Author(s)
Elio TANAKA, Sr., MD1, Hugo Nidahara, RESEARCHER2, Rafael Gama, RESEARCHER2, JOSE MARIO JUNIOR, RESEARCHER2, Goldete Priszkulnik, MSc, MD2, Rogerio Scarabel Barbosa, RESEARCHER2, EDUARDO Ramos, RESEARCHER3.
1MEDICAL AUDIT, TNK MEDICAL AUDIT INSTITUTION, CURITIBA, Brazil, 2TNK, CURITIBA PR, Brazil, 3MEDICAL AUDIT, TNK, CURITIBA PR, Brazil.
1MEDICAL AUDIT, TNK MEDICAL AUDIT INSTITUTION, CURITIBA, Brazil, 2TNK, CURITIBA PR, Brazil, 3MEDICAL AUDIT, TNK, CURITIBA PR, Brazil.
OBJECTIVES: To evaluate the comparative effectiveness and cost-effectiveness of peripherally inserted central catheters compared with centrally inserted central catheters as an economic model aplying for the private oncology set patient .
METHODS: An economic model to a prospective cohort study was followed by an analysis over a 704,000 new cases of cancer expecting for the triennium 2023-2025. The composite outcome was device removal or replacement because of complications before the end of treatment. The economic evaluation was based on a decision tree model for cost-effectiveness analysis, with calculation of the incremental cost-effectiveness ratio (ICER) per catheter removal avoided. All costs are presented in USD (USA ) ( RATE 1:5 ) .
RESULTS: A total of 704,000 cases/ patients were followed in each group; 352.000 ( 50 %) of those receiving a PICC and 50 % of those receiving a CICC had no device-related complication, respectively. Assuming for comparing the events leading to device removal, the risk of composite endpoint was significantly higher in the CICC group (hazard ratio 0.20; 95% CI 0.11-0.35). The cost of PICC placement was USD 258,19 versus USD 93,43 for a CICC. In the base case, the ICER for placing a PICC instead of a CICC was USD 669,98 per removal or replacement avoided. On univariate sensitivity analyses, the model proved to be robust within an ICER range of 500.00 to 960.00 USD .
CONCLUSIONS: In model of Oncologic cases , PICC placement was associated with a lower risk of complications than CICC placement. Although the cost of a PICC is higher, its use avoided complications and need for catheter replacement before the end of treatment.
METHODS: An economic model to a prospective cohort study was followed by an analysis over a 704,000 new cases of cancer expecting for the triennium 2023-2025. The composite outcome was device removal or replacement because of complications before the end of treatment. The economic evaluation was based on a decision tree model for cost-effectiveness analysis, with calculation of the incremental cost-effectiveness ratio (ICER) per catheter removal avoided. All costs are presented in USD (USA ) ( RATE 1:5 ) .
RESULTS: A total of 704,000 cases/ patients were followed in each group; 352.000 ( 50 %) of those receiving a PICC and 50 % of those receiving a CICC had no device-related complication, respectively. Assuming for comparing the events leading to device removal, the risk of composite endpoint was significantly higher in the CICC group (hazard ratio 0.20; 95% CI 0.11-0.35). The cost of PICC placement was USD 258,19 versus USD 93,43 for a CICC. In the base case, the ICER for placing a PICC instead of a CICC was USD 669,98 per removal or replacement avoided. On univariate sensitivity analyses, the model proved to be robust within an ICER range of 500.00 to 960.00 USD .
CONCLUSIONS: In model of Oncologic cases , PICC placement was associated with a lower risk of complications than CICC placement. Although the cost of a PICC is higher, its use avoided complications and need for catheter replacement before the end of treatment.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE486
Topic
Economic Evaluation
Topic Subcategory
Trial-Based Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Infectious Disease (non-vaccine), SDC: Oncology, STA: Surgery