Economic evaluation comparing PICC and short peripheral catheters for OPAT – Full Text

"Increasing PICC use for extended treatments could reduce overall costs and lower ICERs, highlighting their potential economic advantage despite higher initial expenses" Vélez-Bonilla et al (2025).

"Increasing PICC use for extended treatments could reduce overall costs and lower ICERs, highlighting their potential economic advantage despite higher initial expenses" Vélez-Bonilla et al (2025).

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Economic evaluation comparing PICC and short peripheral catheters for OPAT

Abstract:

Introduction: Hospital-at-home programs rely on vascular access devices for secure administration of parenteral antimicrobials. While guidelines recommend peripherally inserted central catheters (PICC) for treatments ≥14 days, short peripheral catheters (SPC) are often used instead. Cost-effectiveness studies comparing these devices and their complications are limited.

Objective: This study conducted an economic evaluation comparing PICC and SPC for patient outpatient parenteral antibiotic therapy.

Materials and methods: A literature review of catheter complication frequencies yielded 1053 papers, narrowed to 18 after independent peer review. Experts were consulted, and a list of items required for catheter use was compiled to determine costs. A decision tree model was developed based on complication frequencies and costs. Results were analyzed using incremental cost-effectiveness ratios (ICER), univariate sensitivity analysis (tornado diagram), and multivariate sensitivity analysis (Monte Carlo simulation).

Results: Major complications were similar between devices, but minor complications were more frequent with SPC. The PICC reference case assumed 50%-50% radiologist/nurse insertion, catheter cost ($74,7), ≤15-day treatment, and complication prevalence. Higher costs associated with PICC were linked to catheter material and radiologist insertion. Multivariate analysis showed ICERs of $49,2 with 90% nurse-led insertion and $24,3 with 100% nurse-led insertions, assuming a 50% PICC price reduction.

Discussion: PICC was more effective in reducing minor complications. Costs decreased with nurse-led insertions and lower catheter material costs.

Conclusion: Increasing PICC use for extended treatments could reduce overall costs and lower ICERs, highlighting their potential economic advantage despite higher initial expenses.

Reference:

Vélez-Bonilla M, Hernández-Flórez C, Solano-Felizzola A, Amado-Garzón SB, Rosselli D. Economic analysis: PICC versus short catheter for prolonged home antibiotic therapy. Rev Cuid. 2025 May 1;16(2):e4124. doi: 10.15649/cuidarte.4124. PMID: 40734730; PMCID: PMC12283088.