Heggie, Robert and Jaiswal, Nishant and McCartney, Elaine and Moss, Jon and Menne, Tobias and Jones, Brian and Boyd, Kathleen and Soulis, Eileen and Hawkins, Neil and Wu, Olivia (2024) Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value in Health, 27 (1). pp. 7-14. ISSN 1098-3015
AI Summary:
The study assessed the cost-effectiveness of three venous access devices (VADs) - Hickman, PICC, and PORT - for patients undergoing long-term anti-cancer therapy. The results showed that PORT was superior to both Hickman and PICC in terms of overall complication rate.AI Topics:
Objectives:
Patients undergoing long-term anti-cancer therapy typically require one of three venous access devices (VADs): HICK, PICC, or PORT. Recent evidence has shown PORT is safer and improves patient satisfaction. However, PORT did not show improvement in quality-adjusted life years (QALYs) and was more expensive. Decisions regarding cost-effectiveness in the UK are typically informed by a cost-per-QALY metric. However, this approach is limited in its ability to capture the full range of relevant outcomes, especially in the context of medical devices. This study assessed the potential cost-effectiveness of HICK, PICC and PORT in routine clinical practice.
Methods:
Cost-consequence analysis to determine the trade-offs between the following outcomes: complication, infection, non-infection, chemotherapy interruption, unplanned device removals, health utilities, device insertion cost, follow-up cost, and total cost, using data from the CAVA clinical trial. We conducted Value of Implementation analysis of a PORT service.
Results:
PORT was superior in terms of overall complication rate, compared with both HICK (IRR: 0.422 (95% CI: 0.286 to 0.622)) and PICC (IRR: 0.295 (95% CI: 0.189 to 0.458)) and less likely to lead to an unplanned device removal. There was no difference in chemotherapy interruption or health utilities. Total cost with device in situ was lower on PORT, compared with HICK (£-98.86 (95% CI: -189.20 to -8.53)) and comparable with PICC -£48.57 (95% CI: -164.99 to 67.86)). Value of Implementation analysis found that PORT was likely to be considered cost-effective within the NHS.
Conclusion:
Decision makers should consider including PORT within the suite of VADs available within in the NHS.
Heggie, Robert
Author
Heggie, Robert and Jaiswal, Nishant and McCartney, Elaine and Moss, Jon and Menne, Tobias and Jones, Brian and Boyd, Kathleen and Soulis, Eileen and Hawkins, Neil and Wu, Olivia (2024) Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value in Health, 27 (1). pp. 7-14. ISSN 1098-3015
See full publications listJaiswal, Nishant
Author
Heggie, Robert and Jaiswal, Nishant and McCartney, Elaine and Moss, Jon and Menne, Tobias and Jones, Brian and Boyd, Kathleen and Soulis, Eileen and Hawkins, Neil and Wu, Olivia (2024) Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value in Health, 27 (1). pp. 7-14. ISSN 1098-3015
See full publications listMcCartney, Elaine
Author
Heggie, Robert and Jaiswal, Nishant and McCartney, Elaine and Moss, Jon and Menne, Tobias and Jones, Brian and Boyd, Kathleen and Soulis, Eileen and Hawkins, Neil and Wu, Olivia (2024) Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value in Health, 27 (1). pp. 7-14. ISSN 1098-3015
See full publications listMoss, Jon
Author
Heggie, Robert and Jaiswal, Nishant and McCartney, Elaine and Moss, Jon and Menne, Tobias and Jones, Brian and Boyd, Kathleen and Soulis, Eileen and Hawkins, Neil and Wu, Olivia (2024) Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value in Health, 27 (1). pp. 7-14. ISSN 1098-3015
See full publications listMenne, Tobias
Author
Heggie, Robert and Jaiswal, Nishant and McCartney, Elaine and Moss, Jon and Menne, Tobias and Jones, Brian and Boyd, Kathleen and Soulis, Eileen and Hawkins, Neil and Wu, Olivia (2024) Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value in Health, 27 (1). pp. 7-14. ISSN 1098-3015
See full publications listJones, Brian
Author
Heggie, Robert and Jaiswal, Nishant and McCartney, Elaine and Moss, Jon and Menne, Tobias and Jones, Brian and Boyd, Kathleen and Soulis, Eileen and Hawkins, Neil and Wu, Olivia (2024) Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value in Health, 27 (1). pp. 7-14. ISSN 1098-3015
See full publications listBoyd, Kathleen
Author
Lai, Tzu-Jung and Roxburgh, Campbell and Boyd, Kathleen Anne and Bouttell, Janet (2024) Clinical effectiveness of robotic versus laparoscopic and open surgery: an overview of systematic reviews. BMJ Open, 14 (9): e076750. ISSN 2044-6055
Heggie, Robert and Jaiswal, Nishant and McCartney, Elaine and Moss, Jon and Menne, Tobias and Jones, Brian and Boyd, Kathleen and Soulis, Eileen and Hawkins, Neil and Wu, Olivia (2024) Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value in Health, 27 (1). pp. 7-14. ISSN 1098-3015
See full publications listSoulis, Eileen
Author
Heggie, Robert and Jaiswal, Nishant and McCartney, Elaine and Moss, Jon and Menne, Tobias and Jones, Brian and Boyd, Kathleen and Soulis, Eileen and Hawkins, Neil and Wu, Olivia (2024) Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value in Health, 27 (1). pp. 7-14. ISSN 1098-3015
See full publications listHawkins, Neil
Author
Bouttell, Janet and Fraser, Heather and Goodlad, John R. and Hopkins, David and McKay, Pam and Oien, Karin A. and Seligmann, Bruce and Von Delft, Stephan and Hawkins, Neil (2024) Adding a gene expression profile test to aid differential diagnosis and treatment in aggressive large B-cell lymphoma: an early exploratory economic evaluation. Applied Health Economics and Health Policy, 22 (2). pp. 243-254. ISSN 1175-5652
Heggie, Robert and Jaiswal, Nishant and McCartney, Elaine and Moss, Jon and Menne, Tobias and Jones, Brian and Boyd, Kathleen and Soulis, Eileen and Hawkins, Neil and Wu, Olivia (2024) Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value in Health, 27 (1). pp. 7-14. ISSN 1098-3015
See full publications listWu, Olivia
Author
Heggie, Robert and Jaiswal, Nishant and McCartney, Elaine and Moss, Jon and Menne, Tobias and Jones, Brian and Boyd, Kathleen and Soulis, Eileen and Hawkins, Neil and Wu, Olivia (2024) Central venous access devices for the delivery of systemic anticancer therapy: an economic evaluation. Value in Health, 27 (1). pp. 7-14. ISSN 1098-3015
See full publications listAvailable under License Creative Commons Attribution.
Download (497kB) | Preview
 |