Economic evaluation on closed infusion of human albumin based on the risk of hospital-acquired infections

Abstract

Objective To evaluate the economy of closed infusion of human albumin injection (albumin) in intensive care unit (ICU) patients from the perspective of the risk of hospital-acquired infections. Methods The data of albumin use in ICU patients in 6 hospitals and the data on hospitalization expenses of patients with catheter related blood stream infections (CRBSI) and matched patients without CRBSI in 15 hospitals in Beijing, Guangdong, Jiangsu, Liaoning, Shandong, Shaanxi, and etc. were collected. Prices of albumin with open or closed infusion system were obtained from Beijing pharmaceutical purchasing platform. A cost-benefit analysis model was established by TreeAge Pro software and the total hospitalization costs of albumin with different infusion system in ICU patients were compared. The robustness of the results was verified by single factor sensitivity analysis and probability analysis. Results When the prices of closed and open infusion of albumin were 424 and 420 yuan respectively, compared with open infusion of albumin, the annual cost of closed infusion of albumin in an ICU would increase by 15 243 yuan (1 615 702 yuan vs. 1 600 477 yuan). However, 1.93 patients with CRBSI (0.94 patients vs. 2.86 patients) would be reduced. The treatment cost of one patient with CRBSI was 53 654 yuan, so 103 016 yuan (50 201 yuan vs. 153 646 yuan) would be saved. Finally, total hospitalization cost of 88 202 yuan (1 665 921 yuan vs. 1 754 123 yuan) would be saved. It was showed by single factor sensitivity analysis that the difference in the price between closed and open infusion of albumin was the key factor affecting the economy. When the price difference was less than 27 yuan, the total hospitalization cost of closed infusion of albumin was lower than that of open albumin infusion. The probability analysis showed that the results are relatively robust. Conclusion Based on the existing models and parameters, it is more economical for ICU patients to use closed infusion of albumin than open infusion, but the result is easily affected by the price difference between the 2 kinds of albumin. Key words: Albumins; Drug packaging; Cross infection; Intensive care units; Economics, pharmaceutical