Accessibility statement

A model to assess the cost-effectiveness of interventions to prevent bloodstream infection in preterm babies

Thursday 21 March 2019, 12.15PM to - 1.15pm

Speaker(s): Alessandro Grosso, CHE, University of York

Abstract: Peripherally Inserted Central Catheters (PICCs) are narrow tubes placed through the skin and into one of the central veins. Their use is essential in babies in Neonatal Intensive Care Units to administer fluids such as medicines or parenteral nutrition, but it increases the risk of infection. Observational evidence suggests a link between infection and long-term adverse consequences including damage to the bowel, permanent neurodevelopmental impairment, and death. Therefore, there has been a considerable effort to develop alternative strategies to prevent infection. One of these is the impregnation of PICCs with antiseptics or antimicrobial substances (AM-PICCs).

Our objective was 3-fold: (1) to develop a de-novo decision analytic model informed by population-specific inputs to assess the long-term costs and consequences of infection and the value of interventions for its prevention; (2) to evaluate the cost-effectiveness of AM-PICCs compared to standard non-impregnated PICCs (S-PICC) given the current evidence; and (3) to identify which areas may warrant further research. This study is part of the larger PREVAIL study, a Phase III RCT evaluating the effectiveness, safety and cost-effectiveness of AM-PICC versus S-PICCs in preterm neonates in the NHS.

The model shows how preventative interventions offer a large potential for cost-effectiveness even when their efficacy is small, under the assumption that infection increases the risk of impairment and death as suggested by observational studies. We conclude that further research is warranted to evaluate the effectiveness of interventions to prevent infections in prematurity. At the same time, there is the need to develop adequate methods to incorporate and assess biases connected to the use of observational evidence in the model structure and evidence synthesis process.

Location: Alcuin A Block A019/20

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Economic evaluation seminar dates

  • Tuesday 28 November 2023
  • Thursday 14 December 2023