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OHP-023 The introduction of the OFF-LINE method for extra-corporeal photochemotherapy (ECP) in Siena University Hospital (AOUS): the economic impact
  1. F Fiori,
  2. D Paoletti,
  3. C Laudisio,
  4. C Castellani,
  5. G Gallucci,
  6. A Tarantino,
  7. MG Rossetti,
  8. S Giorgi,
  9. A Catocci
  1. Azienda Ospedaliera Universitaria Senese, Pharmacy, Siena, Italy

Abstract

Background Extra-corporeal photochemotherapy (ECP) is a procedure that exposes mononuclear blood cells, which have been obtained through centrifugation, to ultraviolet irradiation, in the presence of DNA binding agents such as 8-methoxypsoralen (8-MOP). ECP is mainly used for T-cell-mediated diseases such as organ Graft-versus-host disease (GvHD). Two methods can be used:

ON-LINE, which consists of the irradiation of cells through extracorporeal circulation. This was the only method used in AOUS until 2011 and now it is used only by Dermatology

OFF-LINE, which consist of the leukapheresis of concentrated lymphomonocitary cells, irradiation and subsequently reinfusion. This method was introduced in AOUS in 2012 and it is used by the blood transfusion centre.

Now 8-MOP is prepared in the pharmacy compounding laboratory to ensure greater safety for the staff involved.

Purpose To analyse the costs and consumption data of the Medical Devices (MD) necessary for ECP in the period May 2012–May 2013, and compare with the consumption of the previous years to observe the savings obtained.

Materials and methods We analysed the costs and consumption data of the MDs used in ECP in AOUS, extrapolating from the hospital’s database. Then based on the average historical consumption the resources saved with the introduction of the new method were calculated.

Results During the previous EAHP and SIFO Congress an abstract concerning the off-line method was presented, in which an average consumption of 867 kits/year was calculated, with an annual cost of 914,081 € (in this abstract the costs had also included UV lamps, now provided free of charge) resulting in an estimated saving of about 55% (409,922 €) with the transition to the off-line method. In 2012 with the introduction of the off-line method, the price of kits for the on-line method was also recalculated. In this period (with an average price of 708 € per kit) the hospital consumed 380 kits with a cost of 26,169 € for the online method while the materials related to the off-line method cost 62,469 € (250 kits priced at 247.25 €). Overall in the AOUS we have consumed 630 ECP kits at a cost of 331,637 €.

Conclusions From the analysis of the data we have observed that AOUS reduced its costs by 64% and what was consumed by 19%. The savings exceeded the reduction in the consumption of kits, and therefore the savings do not stem only from the decrease in the number of kits used, but also from the use of the off-line method and its related cost, as well as the renegotiation of the price of the kit for the on-line method. The introduction of the new method, therefore, has produced substantial savings for the AOUS.

No conflict of interest.

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