Centre for Policy Studies, Cork University Business School, University College Cork, Ireland.
Department of Management and Enterprise, Cork Institute of Technology, Cork, Ireland.
Ir J Med Sci. 2019 Aug;188(3):821-834. doi: 10.1007/s11845-018-1925-8. Epub 2018 Nov 22.
In Ireland, over 20,000 people are affected by inflammatory bowel disease (IBD). The licenced biologic therapies to treat moderate to severe IBD are reported to have similar effectiveness levels but differ in their methods of delivery. Certain therapies are administered by intravenous (IV) infusion in the hospital setting, others are delivered by subcutaneous injection in the community.
To determine the non-drug costs involved in administering an IV biologic infusion in the hospital setting.
This time-and-motion study was conducted at an Infusion Day Unit (IDU) in an Irish teaching hospital. The sequence and duration of each patient's use of resources was recorded and costed. Bootstrap methods were applied to ensure that robust estimates of the accuracy of the non-parametric population statistics were reliably estimated.
The mean time the patient spent at the IDU was 143.78 mins with a mean treatment time of 129.81 min. The main driver of patient time was the drug infusion time (39%), followed by the monitoring period (25%). The mean cost was €224.54 per treatment. Nurse time was the main expenditure driver (37%), followed by laboratory costs (27%) and other healthcare professional's costs (14%).
The study confirms that the non-drug costs associated with the delivery of an IV biologic in the hospital setting are non-trivial. Given the current budgetary climate of health systems, the compounding prevalence of IBD and the expected increase in patient numbers, it is imperative that physicians also consider the opportunity costs associated with the method of treatment delivery.
在爱尔兰,超过 20000 人受到炎症性肠病(IBD)的影响。已批准用于治疗中重度 IBD 的生物制剂在疗效方面报告显示相似,但在给药方式上有所不同。某些疗法通过静脉(IV)输注在医院环境中进行,而其他疗法则通过社区中的皮下注射进行。
确定在医院环境中进行 IV 生物制剂输注所涉及的非药物成本。
本时间与动作研究在爱尔兰教学医院的输注日病房(IDU)进行。记录并计算每位患者使用资源的顺序和持续时间。应用引导方法确保可靠地估计非参数总体统计数据的精度的稳健估计。
患者在 IDU 停留的平均时间为 143.78 分钟,平均治疗时间为 129.81 分钟。患者时间的主要驱动因素是药物输注时间(39%),其次是监测期(25%)。每次治疗的平均费用为 224.54 欧元。护士时间是主要支出驱动因素(37%),其次是实验室成本(27%)和其他医疗保健专业人员的成本(14%)。
该研究证实,在医院环境中提供 IV 生物制剂相关的非药物成本相当可观。鉴于卫生系统当前的预算环境、IBD 的复合流行率以及预计患者人数的增加,医生也必须考虑治疗方法给药方式带来的机会成本。