Aulicino Matteo, Orsini Cecilia, D'Annibale Giorgio, Barberis Lorenzo, Catania Paolo, Abatini Carlo, Attalla El Halabieh Miriam, Ferracci Federica, Lodoli Claudio, Santullo Francesco, Pacelli Fabio, Di Giorgio Andrea
General Surgery Department, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Surgical Unit of Peritoneum and Retroperitoneum Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Cancers (Basel). 2024 Jul 24;16(15):2637. doi: 10.3390/cancers16152637.
PIPAC is a new surgical procedure and a viable treatment option for PSM patients, due to promising therapeutic outcomes, minimal invasiveness, limited surgical morbidity, and systemic toxicity side effects. However, its implementation throughout hospitals is hard to obtain due to its fragile economical sustainability. A retrospective health economic analysis was conducted in order to evaluate the cost of hospitalization for patients undergoing PIPAC treatment at Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, in Rome. The average cost of a PIPAC procedure was defined based on the cost of surgery (cost of surgical material, operating room, intraperitoneal chemotherapy), hospital stay, diagnostic examinations, and drugs used during the stay. A total of 493 PIPAC procedures were performed on 222 patients with peritoneal metastases or primary peritoneal cancer from 2017 to 2023. Since the mean remuneration for each PIPAC hospitalization is €5916 and the mean expenditure per hospitalization is €6538, this results in an operating profit per PIPAC hospitalization of -€622. The reimbursement of PIPAC treatment by the Italian National Health System currently only partially covers the hospital's costs. Development of specific codes and adequate reimbursement for PIPAC by recognizing this procedure as a proper treatment for peritoneal carcinomatosis is essential.
腹腔内热灌注化疗（PIPAC）是一种新的外科手术，也是腹膜表面恶性肿瘤（PSM）患者可行的治疗选择，因其具有良好的治疗效果、微创性、较低的手术发病率和全身毒性副作用。然而，由于其经济可持续性脆弱，在各医院难以广泛实施。为评估罗马圣心天主教大学综合医院（IRCCS Fondazione Policlinico Universitario Agostino Gemelli）接受PIPAC治疗患者的住院费用，进行了一项回顾性卫生经济分析。PIPAC手术的平均成本是根据手术费用（手术材料成本、手术室费用、腹腔内化疗费用）、住院时间、诊断检查以及住院期间使用的药物来确定的。2017年至2023年期间，共对222例腹膜转移或原发性腹膜癌患者进行了493次PIPAC手术。由于每次PIPAC住院的平均收入为5916欧元，而每次住院的平均支出为6538欧元，这导致每次PIPAC住院的运营利润为-622欧元。目前，意大利国家卫生系统对PIPAC治疗的报销仅部分覆盖了医院的成本。通过将该手术确认为腹膜癌的适当治疗方法，制定特定代码并给予PIPAC充分报销至关重要。
