PMD79 - COST-EFFECTIVENESS OF ULTRASOUND-GUIDED CENTRAL VENOUS CATHETERISATION FROM THE GERMAN PAYER PERSPECTIVE.

Abstract

To identify the cost-effectiveness of ultrasound guidance versus the landmark method for adults undergoing a central venous catheterization. Since standard central venous cannulation performed by orienting on anatomical landmarks results in high complication rates and failed attempts, an ultrasound guided cannulation is considered as an alternative option. International studies show clinical and economic benefits of ultrasound assistance for central venous cannulation. However, from the German payer perspective cost-effectiveness of ultrasound guidance is unclear. We built a decision-tree based model to estimate the costs of averted catheter-related complications from the perspective of the German Statutory Health Insurance (SHI). The incidence of complications was based on meta-analyses from a Cochrane-Review and the costs of complications were estimated from claims data. To assess the parameter uncertainty, deterministic and probabilistic sensitivity analyzes were performed. Our modelling study shows that the use of ultrasound guidance has a lower rate of complications per person (0.04 versus 0.17 for the landmark method) and was less expensive (€51 versus €230 for the landmark method). Several sensitivity analyzes confirmed the results. Ultrasound guidance might be a more effective and cost saving intervention strategy for the German SHI.