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1ISG-012 The role of the pharmacist in choosing the central venous access device for the prevention of complications: an example of budget impact analysis
  1. A Iezzi,
  2. E Omodeo Salè
  1. Centro Cardiologico Monzino, Servizio di Farmacia Ospedaliera, Milano, Italy


Background In recent years, technological progress has led to the implementation and development of new central peripherally inserted central catheter systems (PICCs) and implanted port (PORTs) to improve patient safety and patient’s quality of life. The economic impact of these innovations, considering the volumes of use in clinical practice, is important for potential complications.

Purpose Our aim was to understand the characteristics of the setting of the two medical device and the possible consequences on the budget of their use. A budget impact analysis (BIA) was conducted.

Material and methods A BIA was performed from the perspective of the regional health system (SSR) and the hospital, and also involved sensitivity analysis involving possible scenarios in normal clinical practice. The direct health costs are included from the hospital perspective: drugs and devices, health personnel, operating room and equipment amortisation. Non-medical direct costs: cleaning, waste, maintenance and administration.

For the regional perspective we consider the refund rate of the procedure.

Results The number of PICCs placed in 2013 was 118 for a cost of €28,320, 211 in 2014 for a cost of €50 640 and 360 in 2015 for a cost of €86 400. The number of PORTs placed in 2013 was 168 for a cost of €21,504, 184 in 2014 for a cost of €23 000 and 214 in 2015 for a cost of €26 750. Estimated cost per hospital patient per placement of the PICC and PORT systems respectively is approximately €458.96 and € 642.53. There is currently no regional reimbursement rate for services rendered under ordinary hospital and day hospital care. Device placement falls within the MAC performance packet (MAC11 for the PORT plant, MAC01–02–03 for the PICC plant) depending on the type of chemotherapy associated with decision No. IX/2946 of the Lombardy Region.

Conclusion In order to prevent complications, the appropriate venous access device should be chosen. The BIA has enabled us to estimate that, to date, the cost of the PICC is less compared with PORT but this placement has not regional reimbursement. Information relating to complications and patient’s quality life is still limited in the literature for this medical device.

No conflict of interest

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