Table 2.
Results of economic analysis presenting average cost for treatment of a pleural effusion in CML
| Health care resource use | Unit cost per events | Number of units | Probability | Invasive procedure subgroup probabilities | Estimated avg cost of treatment per CML patient across all effusions | Estimated avg cost of treatment per patient requiring invasive procedures |
|---|---|---|---|---|---|---|
| Course of diuretics | $8 | 1.29 | 0.68 | 1.00 | $7 | $10 |
| Short course of steroids | $8 | 1.29 | 0.29 | 0.58 | $3 | $6 |
| Chest X-ray (2 views; CPT 71020) | $100 | 2.58 | 1.00 | 1.00 | $258 | $258 |
| ECHO (CPT 93307) | $484 | 1 | 0.38 | 1.00 | $182 | $484 |
| Physician office visits (CPT 99214) | $117 | 2.58 | 1.00 | 1.00 | $301 | $301 |
| Outpatient ultrasound thoracentesis | $713 | 3 | 0.19 | 0.75 | $406 | $1,604 |
| (CPT 32000) or | or | |||||
| Outpatient pleural catheter placement10 | $4,598 | 1 | 0.19 | 0.75 | $874 | $3,449 |
| Inpatient chest tube placement10 | $10,616 | 1 | 0.04 | 0.17 | $446 | $1,805 |
| or | or | |||||
| Inpatient pleural catheter placement10 | $15,170 | 1 | 0.04 | 0.17 | $637 | $2,579 |
| Denver shunt placement* | $3,807 | 1 | 0.04 | 0.17 | $152 | $647 |
| Inpatient pericardial window11 | $15,344 | 1 | 0.02 | 0.08 | $307 | $1,279 |
| Average per patient cost without pleural catheter: | $2,062 | $6,394 | ||||
| Average per patient cost with pleural catheter: | $2,717 | $9,013 | ||||
Notes: Costs in US dollars (2007 rates).
*
Cost estimate was based on the CPT code 49425, insertion of peritoneal venous shunt. Assumptions included a two-day length of stay in general ward at $725/day and two days of physician inpatient visits (CPT 99222 and CPT 99232). Unit costs: Ingenix for CPT codes,8,9 Putnam and colleagues for inpatient chest tube and pleural catheter,10 Girardi and colleagues for inpatient pericardial window,11 and Red Book for drug costs.12