PMD21 Innovative Closed System Devices: Costs Savings, Increased Safety and Multidimensional Impacts

Abstract

To define the benefits concerning the introduction of innovative medical devices for the preparation and administration of chemotherapy agents (integrated or not with traceable workflow), in terms of clinical and economic efficiency, safety (for patients and healthcare professionals), also evaluating the organizational advantages for the hospital, and the accessibility to care, in order to guarantee a positive impact for patients. A Health Technology Assessment was conducted in 2018, comparing four different scenarios differing from their technological level. The nine EUnetHTA Core Model dimensions were deployed considering: i) a systematically evidence; ii) administration of qualitative questionnaires, completed by 34 healthcare professionals (according to 7-item Likert scale, ranging from -3 to +3); and iii) health-economics tools, useful for the economic evaluation of the clinical pathway and budget impact analysis. Literature stated that the introduction of advanced technologies could decrease both the surface (12.24% vs 26.39%,p<0.001) and the healthcare professionals’ contamination (6.3% vs 77.9%,p<0.05), improving the capability to identify dosage errors (7% vs 0.096%,p<0.05), with an overall improvement in professionals’ satisfaction and in the overall organizational climate. From an economic perspective, the most advanced technologies presented the best trade-off between cost sustained and efficacy gained. Budget impact analysis showed hospitals would require marginal investments (from +1% to +6% on average, depending on the hospital base-case scenario and on the technological replacement rate), in case of adoption of the traceable workflow, with a consequent organizational saving equal to more than 1,000 working hours. Professionals declared that, in a condition of complete availability of such medical devices, the innovative technologies could be accessible to all the patients requiring an infusion. The study demonstrated the strategic relevance related to the introduction of advanced technology into the Italian clinical practice, its economic sustainability and feasibility, as well as the potentialities in process improvement.