Cost Evaluation of Dried Blood Spot Home Sampling as Compared to Conventional Sampling for Therapeutic Drug Monitoring in Children

Abstract

Dried blood spot (DBS) sampling for the purpose of therapeutic drug monitoring can be an attractive alternative for conventional blood sampling, especially in children. This study aimed to compare all costs involved in conventional sampling versus DBS home sampling in two pediatric populations: renal transplant patients and hemato-oncology patients. Total costs were computed from a societal perspective by adding up healthcare cost, patient related costs and costs related to loss of productivity of the caregiver. Switching to DBS home sampling was associated with a cost reduction of 43% for hemato-oncology patients (€277 to €158) and 61% for nephrology patients (€259 to €102) from a societal perspective (total costs) per blood draw. From a healthcare perspective, costs reduced with 7% for hemato-oncology patients and with 21% for nephrology patients. Total savings depend on the number of hospital visits that can be avoided by using home sampling instead of conventional sampling.

Effects, costs and implementation of monitoring kidney transplant patients' tacrolimus levels with dried blood spot sampling: A randomized controlled hybrid implementation trial

“…To perform the cost evaluation from a societal point of view, 3 cost categories were identified: patient costs (parking costs and travelling expenses), costs related to loss of productivity (patients' travel time and time in the hospital, caregivers time) and healthcare costs (outpatient clinic visits, laboratory costs, nephrologist phone call, DBS sampling kit and analysis costs). 8 Patient parking costs and traveling distance (in km) were obtained from the Institute for Medical Technology Assessment (iMTA) questionnaire (Supplement S3). [25][26][27] To calculate traveling time (by car) an average speed of 80 km/h was assumed.…”

Improved Dried Blood Spot-Based Metabolomics: A Targeted, Broad-Spectrum, Single-Injection Method

“…Fingerstick lancet and pipetting from vacutainer tubes of collected venous blood are two common methods for DBS preparation. With regard to DBS prepared by fingerstick, it is minimally invasive, requires a small blood volume, and the samples can be collected by the patients themselves and sent to the assigned labs by regular mail with low cost [8]. With regard to DBS prepared by health professionals by pipetting from blood collected in vacutainer tubes, samples stored as DBS may be useful for many applications.…”

Therapeutic drug monitoring of tacrolimus and mycophenolic acid in outpatient renal transplant recipients using a volumetric dried blood spot sampling device

“…The dried blood spot (DBS) approach combined with finger-prick sampling poses a viable strategy to improve outpatient drug monitoring, as it enables the option of home-based TDM [10][11][12]. It thereby creates options for more frequent monitoring based on optimal sampling time points [12], at an overall reduced patient burden and higher cost efficiency [13] as compared with conventional TDM. Over the past decade, various methods for immunosuppressant determination in DBS samples have been described, with the most recent advances including multi-analyte assays for simultaneous quantification of up to five immunosuppressants from one blood spot [14][15][16][17][18][19][20][21].…”