Xu Jia, Zare Hossein, Chiu Herng-Chia, Castillo Renan C
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21202, USA.
Institute for Hospital Management, Tsinghua Shenzhen International Graduate School, Shenzhen 518055, China.
Int J Environ Res Public Health. 2025 Mar 4;22(3):373. doi: 10.3390/ijerph22030373.
BACKGROUND/OBJECTIVES: This study was conducted to assess the cost-effectiveness of chlorhexidine-coated (AGBA) peripheral insertion central catheters (PICCs) versus standard PICCs for managing catheter-related complications among patients with hematologic disease.
A decision tree health economic model was developed, incorporating quality-adjusted life years (QALYs) derived from the literature, as well as complication rates and per-patient costs from a randomized controlled trial. The base case incremental cost-effectiveness ratio (ICER) was assessed against established willingness to pay (WTP) thresholds. One-way sensitivity analyses were conducted to address assumptions and uncertainties.
The mean healthcare cost per patient of standard PICCs was RMB 21,987.32 (USD 3242.82, at an average exchange rate of RMB 678.03 = USD 100), affecting 0.68 QALYs in 90 days. The mean healthcare cost per patient of AGBA PICCs was RMB 19,696.23 (USD 2904.92), affecting 0.73 QALYs in 90 days, thus resulting in a saving of RMB 2291.10 (USD 428.44). After the model simulation, standard PICCs resulted in a reduction of 0.05 QALYs. The ICER for AGBA PICCs compared with standard PICCs was consistently centered at RMB 4271.31 (USD 629.96).
one-way sensitivity analyses of cost-effectiveness versus WTP confirmed the robustness of the model across various parameter changes, indicating that AGBA PICCs could provide significant healthcare savings over a 1-year period when adopted in routine chemotherapy treatment for patients with hematologic disease.
背景/目的：本研究旨在评估氯己定涂层（AGBA）外周静脉穿刺中心静脉导管（PICC）与标准PICC在管理血液系统疾病患者导管相关并发症方面的成本效益。
建立了一个决策树健康经济模型，纳入了从文献中得出的质量调整生命年（QALY），以及一项随机对照试验的并发症发生率和患者人均成本。根据既定的支付意愿（WTP）阈值评估基础病例增量成本效益比（ICER）。进行了单向敏感性分析以解决假设和不确定性问题。
标准PICC的患者人均医疗费用为21,987.32元人民币（3242.82美元，平均汇率为678.03元人民币 = 100美元），90天内影响0.68个QALY。AGBA PICC的患者人均医疗费用为19,696.23元人民币（2904.92美元），90天内影响0.73个QALY，从而节省了2291.10元人民币（428.44美元）。模型模拟后，标准PICC导致QALY减少0.05。与标准PICC相比，AGBA PICC的ICER始终集中在4271.31元人民币（629.96美元）。
成本效益与WTP的单向敏感性分析证实了该模型在各种参数变化下的稳健性，表明AGBA PICC在用于血液系统疾病患者的常规化疗治疗时，可在1年内显著节省医疗费用。
