OBJECTIVES: To develop a health economic budget impact model to estimate the direct medical cost savings when replacing a non-antimicrobial intravascular (IV) catheter site dressing with an antimicrobial, chlorhexidine-containing IV catheter securement dressing in oncology patients with a central venous catheter (CVC).

METHODS: A static decision tree model was used to estimate the budget impact of implementing a chlorhexidine-containing dressing from a UK hospital payer perspective. The model time horizon is one year. Two types of CVC, with different incidence rates of infectious complications and cost parameters, were included. Catheter-related bloodstream infection (CRBSI) incidence rates were 1.40 and 0.53 per 1,000 catheter days for tunnelled and non-tunnelled CVC, respectively. Local site infection incidence rates (LSI) were 0.72 and 0.19 per 1,000 catheter days for tunnelled and non-tunnelled CVC, respectively. Re-catheterisation occurred in 66% and 16% of tunnelled CVC CRBSI and LSI cases, respectively, and 60% of non-tunnelled CVC CRBSI cases. Re-catheterisation costs were £1,108 and £510 for tunnelled and non-tunnelled CVC, respectively. Treatment costs of CRBSI and LSI were £7,790 and £108 per case, respectively. Weekly costs of dressing replacement were £2.10 and £5.43 per patient for non-antimicrobial and chlorhexidine-containing dressing groups, respectively. The chlorhexidine-containing dressing efficacy to reduce CRBSI and LSI is derived from the literature (49.8%). Parametric uncertainty was evaluated with a one-way sensitivity analysis.

RESULTS: In a hypothetical oncology centre with 424 patients and 51,218 catheter days a year, the total direct medical cost savings are £222,991 (including £19,029 in re-catheterisation costs), outweighing the increased dressing replacement costs of £27,235. The intervention efficacy and cost of CRBSI were the most influential parameters identified in the one-way sensitivity analysis.

CONCLUSIONS: Implementing a chlorhexidine-containing dressing in oncology patient catheter site care is a cost saving intervention and should be considered where infection rates remain a concern.