Table 5.
Cost and sensitivity analysis of modified intention‐to‐treat population
| 2% taurolidine (n = 52) | 0.9% saline (n = 50) | P value | |
|---|---|---|---|
| Catheter lock solution costs | |||
|
Study treatment—days CLS price per daya Total cost of catheter lock solution—USD Mean cost of catheter lock solution per patient—(95% CI)b |
15 318 3.48 45 949 884 (772‐998) |
12 493 0.70 7879 158 (131‐183) |
<0.001 |
| Resource use | |||
|
Hospital admissions due to CRBSIs—no. Total hospital admission days Ward Intensive care unit Total cost of hospital admissions—USDc Mean cost of hospital admissions per patient—(95% CI)b |
5 161 145 16 122 701 2360 (42‐6810) |
18 229 229 0 160 970 3219 (1865‐4798) |
0.70 |
|
Outpatient clinic consultations—no. Total cost of consultations—USDc Mean cost of consultations per patient—(95% CI)b |
0 0 0 (0‐0) |
1 178 4 (0‐12) |
0.12 |
|
Antimicrobial treatment—days Cost of drug treatment—USDd Mean cost of drug treatment per patient—(95% CI)b |
325 53 339 1026 (12‐3329) |
423 32 423 648 (176‐1376) |
0.71 |
|
CVAD changes Cost of CVAD changes—USDe Mean cost of CVAD changes per patient—(95% CI)b |
3 7974 153 (0‐412) |
8 21 264 425 (170‐702) |
0.12 |
|
Total costs—USD Costs per treatment day—USD Costs per treatment year—USD Total costs per patient in USD—mean (95% CI)b |
229 963 15.0 5491 4422 (978‐11 350) |
222 715 17.8 6507 4454 (2631‐6579) |
>0.99 |
| Sensitivity analysis f | |||
|
Total costs—USD Costs per treatment day—USD Costs per treatment year—USD Total costs per patient in USD—mean (95% CI)b |
96 994 6.3 2311 1865 (1016‐2931) |
222 715 17.8 6507 4454 (2631‐6579) |
0.03 |
CI, confidence interval; CRBSI, catheter‐related bloodstream infection; CVAD, central venous access device; USD, United States dollar.
Price of 2% taurolidine (TauroSept) per day in the Netherlands: $3.48. Price of 0.9% saline solution per day: $0.70.
Costs (USD) were compared using an independent samples t test after bootstrapping (1000 simulations).
Hospital admission and outpatient clinic consultation prices are based on the Dutch guidelines for conducting economic evaluations in healthcare (2016) from Zorginstituut Nederland (The Netherlands Healthcare Institute).22 Price of 1‐day ward admission: $703. Price of 1‐day intensive care unit: $1299. Price of outpatient clinic consultation: $178.
CRBSI drug treatment prices are based on medicijnkosten.nl (2016) from Zorginstituut Nederland (The Netherlands Healthcare Institute).23
Price of CVAD change in the Netherlands (including costs CVAD, operation room, surgeon, anaesthetics): $2658.
One patient was a major outlier in the taurolidine arm with 67% ($153 435) of the total taurolidine costs. In a sensitivity analysis, the patients costs were adjusted by winsorising (the original value was replaced by the nearest value of an observation not seriously suspect) the hospital admission ($14 059 instead of $96 693) and drug treatment costs ($785 instead of $51 120) in the taurolidine arm.