OBJECTIVES

The Colombian Health Promoters (EPS) reimburse Therapeutic Plasma Exchange (TPE) procedures in most Colombian hospitals. The purpose of this research is to acknowledge, from the hospital management perspective, the most profitable TPE system for that center; and analyze which cost drivers have the highest economical impact.

METHODS

Data from 5 different hospitals from Cali and Bogotá have been collected, including drivers of costs and technical parameters. Additional clinical data have been used from Systematic literature reviews in both PubMed and the ISPOR Scientific Presentations Database.

Several scenarios have been created to objectify differences between (1) Device and disposable costs per procedure (2) Clotting costs (3) Procedural costs (4) Venous access costs (5) Adverse events costs, and a tornado chart will be performed to visually demonstrate the relations among these 5 variables.

For each scenario, a simulation model with 10,000 computerized iterations was performed to account for potential local variances.

RESULTS

Device and disposable costs per procedure are the highest costs for TPE, from 65-75% of the total mTPE costs, to 85-95% in cTPE. Clotting costs are the second highest in mTPE, around 20% of total costs, but extremely low in cTPE, <1%. Venous access and procedural costs amounted together around 5% in both systems. cTPE had higher costs in venous access and lower costs in the procedural one, and mTPE viceversa. Adverse events, due to its low incidence, had the lowest costs in both systems, <1%.

CONCLUSIONS

From a hospital management perspective, to achieve the most cost-effectiveness TPE system, device, disposable costs and clotting costs should be assessed. In more than 95% of the computerized iterations, cTPE was found the most profitable option, with a possible EPS reimbursement to more than 200% of the total hospital costs per procedure.