REDUCED NEEDLESTICK INJURIES AND HBV INFECTIONS IN CHINESE HEALTHCARE WORKERS FROM BLUNT-TIP SUTURE NEEDLES IN CESAREAN SECTIONS- A MARKOV SIMULATION
Author(s)
Kong L1, Zheng Y2, Lee SH3
1Johnson & Johnson, Shanghai, China, 2Johnson & Johnson, Ethicon, Shanghai, China, 3Johnson & Johnson Medical, Asia Pacific, Singapore, Singapore
OBJECTIVES: To compare the disease burden and health-related costs of contracting Hepatitis B Virus (HBV) following a needlestick injury in Chinese Healthcare Workers (HCWs) when using normal versus blunt-tip needle sutures in cesarean sections over a 10-year time horizon.
BACKGROUND & METHODS: Needlestick injuries can lead to a number of blood-borne infectious diseases i.e. HIV, HBV, or HCV for HCWs exposed to contaminated needles, and contribute to great mental anxiety, reduced productivity, and potentially high treatment costs. For several years, professional organizations such as the WHO have endorsed the use of blunt-tip needle sutures as a preventive and occupational safety measure. Here, a Markov model was built to estimate and compare the HBV infection rate and the total treatment costs per HCW between normal and blunt-tip needle groups. The needlestick injury rate in c-sections, HBV infection rate, healthcare costs, Markov states and transition probabilities were collected from three epidemiology papers targeting Chinese populations.
RESULTS: Although blunt-tip needle sutures command a marginal price premium, they appreciably reduce the incidence of needlestick injuries to surgical personnel (Blunt: 1%, Normal: 6%; p<0.05) and lower treatment costs compared to normal needles. Specifically: (1) The adoption of blunt-tip suture needles reduces HBV infection rates (93 HBV infections/1,000,000 c-sections vs. 557 HBV infections/1,000,000 c-sections), which may be especially pertinent for obstetrics departments performing >1,795 c-sections per year; (2) The net cost benefit per HBV prevented is 112,069 RMB; (3) The 10-year average costs of HBV treatment per HCW is 338,757 RMB; and (4) In case of HBV infection, there is a 1.3% risk of progression to hepatocellular carcinoma (HCC) within 10 years.
CONCLUSIONS: Based on our study outcomes, the application of blunt-tip needle sutures is associated with a significant reduction in HBV infections and health-related costs in the Chinese context. It may be recommended for clinical use.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PMD49
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Infectious Disease (non-vaccine)
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