Stem Cell Mobilization and Collection Unit, Istituto Europeo di Oncologia IRCCS, Milan, Italy.
J Clin Apher. 2021 Jun;36(3):364-369. doi: 10.1002/jca.21870. Epub 2021 Jan 21.
Stem Cell Mobilization and Collection Unit at Istituto Europeo di Oncologia (IEO; Milan, Lombardia) provides extracorporeal photopheresis (ECP) therapy to treat graft-vs-host disease (GvHD) using offline procedures. ECP can be administered via an integrated single device (online procedure). Total cost of performing ECP at IEO vs an integrated device was assessed using a micro-costing approach.
Ten offline ECP procedures for GvHD were monitored using Time-Driven Activity-Based Costing methodology, which utilized costs of resources, and time spent by patients/healthcare personnel with each resource. Details of ECP steps were recorded (pre-/post-treatment clinical evaluations, biological sampling, cannulation, apheresis, irradiation, reinfusion time). Time and cost comparisons between offline (combination of equipment/devices) and online technologies (THERAKOS™ CELLEX™ Photopheresis System) were performed. Cost variables: consumables, personnel, equipment, and laboratory tests. Personnel costs for online procedures were calculated using published time estimates and IEO hourly rates. Costs recorded in 2018 euros.
Median duration of IEO offline ECP procedures (296 minutes) was greater than that reported for CELLEX ECP delivery (120 minutes). Total cost of offline ECP (€1134.57 [$1314.57]/procedure) was greater than that reported for online delivery (€1063.95 [$1232.74]/procedure). IEO performs ~84 ECP procedures/y, which would require ~412 hours/y vs 168 hours/y for online procedures; suggesting €5932.08 [$6873.72]/y savings with online procedures.
This assessment highlights potential resource time savings with online procedures. Time saved could allow increased activity with the same resources, at a department level. Potential non-monetary benefits include reduced time burden on patients, increased availability of hospital staff and improved patient safety.
欧洲肿瘤研究所（IEO；米兰，伦巴第）的干细胞动员和采集科采用离线程序为移植物抗宿主病（GvHD）提供体外光分离术（ECP）治疗。ECP 可以通过集成的单个设备（在线程序）进行给药。采用微观成本法评估 IEO 进行 ECP 的总成本与集成设备相比。
采用时间驱动的作业成本法监测了 10 例用于 GvHD 的离线 ECP 程序，该方法利用资源成本和患者/医疗保健人员使用每种资源的时间。记录了 ECP 步骤的详细信息（治疗前后临床评估、生物样本采集、置管、单采、辐照、再输注时间）。比较了离线（设备/仪器组合）和在线技术（THERAKOS CELLEX 光分离术系统）之间的时间和成本。成本变量：耗材、人员、设备和实验室测试。在线程序的人员成本是根据已发表的时间估算和 IEO 小时费率计算的。以 2018 年欧元记录成本。
IEO 离线 ECP 程序的中位持续时间（296 分钟）长于 CELLEX ECP 输送的报告时间（120 分钟）。离线 ECP 的总费用（€1134.57 [1314.57]/程序）高于在线输送的报告费用（€1063.95 [1232.74]/程序）。IEO 每年进行约 84 例 ECP 程序，这将需要每年约 412 小时，而在线程序每年需要 168 小时；表明在线程序每年可节省 5932.08 欧元[6873.72]。
该评估突出了在线程序在资源时间方面的潜在节省。节省的时间可以使部门层面的相同资源增加活动。潜在的非货币效益包括减少患者的时间负担、增加医院工作人员的可用性和提高患者安全性。
