OBJECTIVES: Estimate the health economic impact associated with nurse-based (RN) increased use of Sherlock 3CG® Tip Confirmation System (TCS) for intensive care unit (ICU) and non-ICU bedside peripherally inserted central catheter (PICC) placements compared to current physician-based interventional radiology (IR) department PICC placement (e.g., confirmatory chest x-ray) and physician-based centrally inserted central catheters (CICC) insertion procedures.

METHODS: A model was developed to estimate health economic outcomes over a three-year time horizon. For the current mix, it was assumed that all non-ICU patients received IR PICC placement and the majority of ICU patients received CICC placement. The future mix assumed that all eligible patients receiving IR PICC placement (~93%) switched to Sherlock 3CG® TCS. Tray, kit, and operational costs were assessed. Differences in staff time were also estimated. Inputs were derived from published literature where available. Sensitivity analyses, such as varying unit costs and utilization inputs were conducted to test a range of assumptions.

RESULTS: Increased use of Sherlock 3CG® TCS was predicted to result in procedural cost savings when compared with current conventional PICC placements in the IR. In the base case, for an estimated population size of 1,325 annual patients, the cumulative three-year cost-savings were predicted to be $734,328. In addition, increased use of bedside PICC placement with Sherlock 3CG® TCS was predicted to reduce resource use (e.g., physician or IR staff time) when compared with conventional PICC placement in the IR. Finally, Sherlock 3CG® TCS was predicted to be cost-saving in the majority of sensitivity analyses.

CONCLUSIONS: These analyses suggest that increased use of RN-based Sherlock 3CG® TCS may reduce the clinical, resource, and economic limitations associated with physician-based IR PICC placement methods. These analyses were not based upon head-to-head clinical comparisons and therefore additional data would help to further elucidate these findings.