COST-BENEFIT ANALYSIS OF CLOSED-SYSTEM AND OPEN-SYSTEM INFUSION OF HUMAN SERUM ALBUMIN IN ICU PATIENTS
Author(s)
Yifei Jian, Master1, Kejing Tang, PhD2, Xiaoyan Xue, PhD3, Peng Zhang, PhD4, Congrong Wang, PhD5, Yongbo Gao, Master6, Jianwei Xuan, PhD7, Xiaolan Bian, PhD8.
1Health Economics Research Institute, School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China, 2Department of Pharmacy, The First Affiliated Hospital of Sun Yatsen University, Guangzhou, China, 3Department of Intensive Care Unit, Aerospace Center Hospital, Beijing, China, 4Departent of Pharmacy, Shanxi Provincial People's Hospital, Xi'an, China, 5Pharmacy Center, Shandong Public Health Clinical Center, Jinan, China, 6Medical Affairs, Takeda (China) International Trading Company, Beijing, China, 7Health Economic Research Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China, 8Departent of Pharmacy, Ruijin Hospital, School of Medicine. Shanghai Jiaotong University, Shanghai, China.
1Health Economics Research Institute, School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China, 2Department of Pharmacy, The First Affiliated Hospital of Sun Yatsen University, Guangzhou, China, 3Department of Intensive Care Unit, Aerospace Center Hospital, Beijing, China, 4Departent of Pharmacy, Shanxi Provincial People's Hospital, Xi'an, China, 5Pharmacy Center, Shandong Public Health Clinical Center, Jinan, China, 6Medical Affairs, Takeda (China) International Trading Company, Beijing, China, 7Health Economic Research Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China, 8Departent of Pharmacy, Ruijin Hospital, School of Medicine. Shanghai Jiaotong University, Shanghai, China.
OBJECTIVES: The study aims to evaluate the costs and benefits associated with closed-system (bagged) versus open-system (bottled) albumin infusion in intensive care units (ICU) in China from different research perspectives.
METHODS: A one-year decision tree model was constructed to simulate the costs and benefits of using different packaging types of albumins for 100 ICU patients. Model inputs were obtained from published literature, public websites, and clinical expert interviews. Deterministic and probabilistic sensitivity analyses were performed to address the robustness and uncertainty.
RESULTS: In terms of cost, the closed-system albumin had a higher drug cost ($89,623 vs. $83,972), but it had lower hospitalization costs ($1,564,513 vs. $1,572,417), drug preparation costs ($45 vs. $107), and storage and management costs ($343 vs. $935) compared with open-system albumin. From different perspectives, the closed-system albumin saved the following average costs per case: $29.07 (healthcare provider’s perspective), $7.23 (patient perspective) and $13.51 (payer’s perspective). Regarding consequences, closed-system albumin compared to open-system albumin resulted in lower mortality (28.36% vs. 32.80%), central line-associated bloodstream infection (CLABSI) incidence rate (0.60% vs. 1.84%), ICU bed occupancy rate (18.29% vs. 18.47%), ICU infection-related complications rate (19.14% vs. 19.40%), and ICU secondary endocarditis incidence rate (0.15% vs. 0.36%). Additionally, closed-system albumin reduced ICU length of stay (16.69 days vs. 16.86 days) without affecting general ward length of stay. It also saved 218 minutes of drug preparation time and reduced medication waste for 100 simulated patients. Both deterministic and probabilistic sensitivity analysis demonstrated the robustness of the model results.
CONCLUSIONS: The use of closed-system albumin in ICU patients was found to be more cost-effective than open-system albumin, offering benefits to healthcare providers, patients, and payers.
METHODS: A one-year decision tree model was constructed to simulate the costs and benefits of using different packaging types of albumins for 100 ICU patients. Model inputs were obtained from published literature, public websites, and clinical expert interviews. Deterministic and probabilistic sensitivity analyses were performed to address the robustness and uncertainty.
RESULTS: In terms of cost, the closed-system albumin had a higher drug cost ($89,623 vs. $83,972), but it had lower hospitalization costs ($1,564,513 vs. $1,572,417), drug preparation costs ($45 vs. $107), and storage and management costs ($343 vs. $935) compared with open-system albumin. From different perspectives, the closed-system albumin saved the following average costs per case: $29.07 (healthcare provider’s perspective), $7.23 (patient perspective) and $13.51 (payer’s perspective). Regarding consequences, closed-system albumin compared to open-system albumin resulted in lower mortality (28.36% vs. 32.80%), central line-associated bloodstream infection (CLABSI) incidence rate (0.60% vs. 1.84%), ICU bed occupancy rate (18.29% vs. 18.47%), ICU infection-related complications rate (19.14% vs. 19.40%), and ICU secondary endocarditis incidence rate (0.15% vs. 0.36%). Additionally, closed-system albumin reduced ICU length of stay (16.69 days vs. 16.86 days) without affecting general ward length of stay. It also saved 218 minutes of drug preparation time and reduced medication waste for 100 simulated patients. Both deterministic and probabilistic sensitivity analysis demonstrated the robustness of the model results.
CONCLUSIONS: The use of closed-system albumin in ICU patients was found to be more cost-effective than open-system albumin, offering benefits to healthcare providers, patients, and payers.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE315
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Infectious Disease (non-vaccine)