Economic evaluation of standard versus integrated short peripheral catheters
Davide Giustivi, Arianna Bartoli, Alessia Meschia, Federica Cirigliano, Teresa Lanzi, Beatrice Tramalloni, Maria Calloni, Paolo Zappa, Alba Taino, Matteo Maria Masseroli, Francesco Casella, Antonella Foschi, Marco Gemma, Roberto Castelli, Antonio GidaroBackground:
Integrated short peripheral catheters (ISPCs) have been developed to reduce the risk of catheter failure compared with traditional short peripheral catheters (SPCs). Although clinical benefits have been demonstrated in randomized studies, economic evidence remains inconsistent.
Objective:
To perform a hospital‑perspective, model‑based economic evaluation comparing ISPCs and SPCs.
Methods:
The base-case model was a patient-level Monte Carlo simulation estimating per-patient costs for ISPCs versus SPCs. This was complemented by one-way deterministic sensitivity analyses with tornado ranking and break-even thresholds, a time-to-first-event (TTF) structural scenario analysis calibrated to published failure hazards, and additional model outputs from a probabilistic sensitivity analysis reported as a cost-effectiveness acceptability curve (CEAC). Model inputs included pooled event rates for occlusion, dislodgement, infiltration, and thrombophlebitis, as well as cost components for device acquisition, nursing labor, and complication management.
Results:
The Monte Carlo simulation estimated a mean per‑patient cost of €73.04 for ISPCs versus €80.02 for SPCs, corresponding to average savings of €6.98 and a 96.7% probability that ISPCs were cost‑saving. Sensitivity analyses confirmed robustness across ±20% variation in complication costs. In the TTF model at 96 h, ISPCs remained cost‑saving (€−3.40) under a hazard ratio of 0.82, with larger savings observed at longer dwell times and more favorable hazard assumptions. The CEAC indicated an 87.5% probability that ISPCs were cost‑saving at a willingness‑to‑pay of zero, rising to over 99% at higher thresholds.
Conclusions:
ISPCs offer a high probability of per‑patient cost savings. Adoption appears economically advantageous for patients requiring peripheral IV access beyond 72 h.