Economic evaluation of the use of pre-filled syringe versus manually filled syringe paraflushing in patients with central venous cateter in the perspective of health careers

Abstract

Objective: The advancement of technology in the health sector has brought, mainly to the Health Insurances, a discussion on what is the best path for the incorporation of new medical and hospital products. The objective of this study is to do a cost analysis comparing a new technology (pre-filled syringe) with a usual technology (manually filled syringe) in patients in use of central venous catheter (CVC). Methods: An economic assessment based on a Decision Tree model was developed to evaluate the commercially pre-filled syringe in comparison to the manually filled syringe with saline solution for flushing in patients with CVC, considering the perspective of private health care providers. The time horizon considered was 1 year. As clinical outcomes, the occurrence of central line-associated blood stream (CLABSI) and occlusions were adopted. For economic outcomes, we considered flush costs, reduction of CLABSI and occlusion. All costs were extracted from local cost database for Brazil. Results: The economic evaluation indicated that the use of the pre-filled syringe presented a reduction of 77% (1.17 vs. 5.10) and 62% (3.26 vs. 8.57) in the occurrences of CLABSI and occlusion, respectively, compared to the manually filled syringe. The cost per flushing is R$ 32.88 and R$ 98.48 for pre-filled syringe and manually filled syringe, respectively, representing an absolute reduction of R$ 65.60 and percentual of 67%. Conclusion: The use of the commercially pre-filled syringe has been shown to be an economically and clinically dominant option for flushing in patients with CVC when compared to the manually filled syringe.