PMD17 Noble Metal Alloy-Coated Urethral Catheter: A Budget Impact analysis in the Veneto Region of Italy

Abstract

The aim of this paper is to illustrate a methodology to develop a BIA, assisting the decision maker in answering the question on financial sustainability. The analysis compared the new coated urethral catheter (alternative A) to the long-term catheter currently in use in the region (alternative B). The study, built on efficacy data including “asymptomatic bacteriuria” solely, adopted the perspective of the Regional Health Service. A survey was conducted in seven local health authorities (LHAs) within the Region to obtain consumption data and the average price of respectively the new and currently used long-term catheters. The estimate of regional consumption of alternative B was obtained by projecting the consumption of 7 LHAs on the basis of the percentage of total inpatient admissions. The analysis included technology costs and the costs of additional hospitalization days due to Catheter Associated Urinary Tract Infections (CAUTI). Sensitivity analyses were conducted to test the robustness of the results in the “base case”. In 2010 approximately 25.000 long-term catheters with an average price of 3.57 € were consumed. The regional estimate of annual consumption is about 221.560 catheters, with a total cost of € 791.000 per year. In the case of adopting alternative A, the base case analysis estimated savings of around € 200.000 per year. The one-way sensitivity analysis confirmed the extreme variability of the final result as a function of the confidence interval of the clinical efficacy. A more favorable result for the new catheter can be reached using a “two-way” analysis, combining a higher CAUTI incidence and a higher level of effectiveness (€2.045.866). The results are strongly influenced by the effectiveness of the new technology: a slight clinical benefit is enough to make the new catheter economically viable.