Year: 2025
Type: article
Abstract: Highlights Guidelines recommend using peripherally inserted central catheters for treatment lasting more than 14 days. This study suggests that, compared to short peripheral catheters, peripherally inserted central catheters are more effective in preventing minor complications and subsequent catheter failure during prolonged parenteral antimicrobial therapy. Peripherally inserted central catheters remain more expensive than short peripheral catheters due to higher insertion and material costs. Nurse-led insertion of peripherally inserted central catheters may reduce costs for patients requiring prolonged parenteral antimicrobial therapy, leading to possible reductions in the incremental cost-effectiveness ratio. Introduction: Hospital-at-home programs rely on vascular access devices for secure administration of parenteral antimicrobials. While guidelines recommend peripherally inserted central catheters (PICC) for treatments ≥14 days, short peripheral catheters (SPC) are often used instead. Cost-effectiveness studies comparing these devices and their complications are limited. Objective: This study conducted an economic evaluation comparing PICC and SPC for patient outpatient parenteral antibiotic therapy. Materials and Methods: A literature review of catheter complication frequencies yielded 1053 papers, narrowed to 18 after independent peer review. Experts were consulted, and a list of items required for catheter use was compiled to determine costs. A decision tree model was developed based on complication frequencies and costs. Results were analyzed using incremental cost-effectiveness ratios (ICER), univariate sensitivity analysis (tornado diagram), and multivariate sensitivity analysis (Monte Carlo simulation). Results: Major complications were similar between devices, but minor complications were more frequent with SPC. The PICC reference case assumed 50%-50% radiologist/nurse insertion, catheter cost ($74,7), ≤15-day treatment, and complication prevalence. Higher costs associated with PICC were linked to catheter material and radiologist insertion. Multivariate analysis showed ICERs of $49,2 with 90% nurse-led insertion and $24,3 with 100% nurse-led insertions, assuming a 50% PICC price reduction. Discussion: PICC was more effective in reducing minor complications. Costs decreased with nurse-led insertions and lower catheter material costs. Conclusions: Increasing PICC use for extended treatments could reduce overall costs and lower ICERs, highlighting their potential economic advantage despite higher initial expenses. How to cite this article: Vélez- Bonilla Mariana, Hernández- Flórez Catalina, Solano-Felizzola Allan, Amado-Garzón Sandra B, Rosselli Diego. Economic analysis: PICC versus short catheter for prolonged home antibiotic therapy. Revista Cuidarte. 2025;16(2):e4124. https://doi.org/10.15649/cuidarte.4124
Source: Revista CUIDARTE
Language: English
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4410085208