Evaluating the Cost Effectiveness of Using Lubricant Impregnated Surface Technology on Intravascular Catheters to Reduce Healthcare-Acquired Infections

Abstract

This case study evaluates the cost effectiveness of developing lubricant impregnated surface technology (LIST)-coated intravascular catheters to decrease medical costs related to catheter-related blood stream infections (CRBSIs) and the associated patient morbidity and mortality in the two largest medical device markets, the United States (U.S.) and the European Union (E.U.). This analysis considers both the potential societal benefits (in terms of decreased morbidity and mortality and reduced healthcare costs) and the costs for an individual firm to secure regulatory approval. By using a cost effectiveness analysis (CEA) framework, this case study: identifies the possible outcomes of continuing to use standard catheters versus beginning to use LIS-coated catheters, estimates the probability and monetized cost of each possible outcome, and compares the expected value of each outcome. In the societal-level analysis, the reduced probability of CRBSIs and associated cost savings are forecast by considering nine scenarios where efficacy of LIS-coated catheters ranges from 10 to 90 percent. In the 10 percent scenario, morbidity would be reduced by approximately 47,000 cases and mortality by approximately 8,000 cases, with total cost savings of approximately $1.6 billion in the U.S. and E.U. combined. In the 90 percent scenario, morbidity would be reduced by approximately 420,000 cases and mortality by approximately 72,000 cases, with total cost savings of approximately $14.0 billion in the U.S. and E.U. combined. This represents an average per-catheter savings ranging from $118 to $1,060. The firm-level analysis forecasts that a catheter firm could realize additional annual revenues between $15.0 and $73.0 million for the combined U.S. and E.U. markets. The expected break-even period to recoup the initial costs of regulatory approval is two to six years in the E.U. and six to twelve years in the U.S.