The Economic Impact of Using Antimicrobial Catheters Impregnated with Rifampin and Clindamycin to Reduce Infection Rates in External Ventricular Drainage: A Budget Impact Analysis

Abstract

A 3 4 7 -A 7 6 6 was developed to capture the expected cost of care and the potential payback stemming from new device deployment over a 3-year time horizon in Scotland. Daily cost of care for PU (including potential complications), length of stay and probability of complications were derived from the literature including a cost breakdown in labor and material costs. A comparison was performed between the scenarios with and without the new device, based on assumptions on early diagnosis rates and grade I PU prevention for the diagnostic tool. Number of PU cases and associated costs of care were derived in both scenarios. Results: Based on the assumption that the new device would prevent 80% of early stage PU episodes, 10,813 annual cases are expected to be averted in the 1st year following the deployment of the device. After deducting the costs associated to the new device, this would entail cost savings of almost £55M in 1st year (£35M of which imputable to labor) and £177M over 3 years. ConClusions: Based on this study, the initial cost associated to the purchase of the new device would be offset by the savings stemming from reduced costs of care due to reduced number of PU cases. Savings would be generated from the 1st year and expected to grow in the following ones.objeCtives: DuoResp® Spiromax® is a dry powder inhaler delivering a fixed-dose combination of budesonide + formoterol for the treatment of adults with asthma or chronic obstructive pulmonary disease (COPD). Post-hoc analysis of the ELIOT trial -a parallel-group, open-label study -showed that significantly fewer people using DuoResp® Spiromax® had poor inhalation technique compared with Symbicort® Turbuhaler®. A budget impact model was developed to assess the potential impact, from a Polish healthcare payer perspective, of improved inhalation technique on unscheduled healthcare events and costs when switching patients from Symbicort® Turbuhaler® to DuoResp® Spiromax® over five years. Methods: The eligible patient population was estimated using epidemiological study and inhaler sales data for Poland. Costs and resource use estimates were taken from publicly-available sources and peer-reviewed studies. The frequency of poor inhalation technique with Symbicort® Turbuhaler® and the associated increased risk of unscheduled healthcare events were derived from a cross-sectional Italian study. The reduction in poor inhalation technique associated with DuoResp® Spiromax® was based on observations from the ELIOT trial. Two scenarios were modelled: in A, all patients were immediately switched from Symbicort® Turbuhaler® to DuoResp® Spiromax®; in B, patients were switched gradually, from 4% in year 1 to 15% in years 4-5. Results: An estimated 48,674 patients used Symbicort® Turbuhaler® annually. Of these, 21,173 exhibited poor inhalation technique, which was associated with a total estimated annual cost of € 281,042. In Scenario A, 1,879 unscheduled healthcare events were avoided due to improved inhalation technique, resulting in estimated cost savings totallin...