Balancing Costs and Clinical Outcomes: A Cost-effectiveness Study of PICC Types Across Chinese Healthcare Settings

Long-term intravenous therapies often necessitate the use of peripherally inserted central catheters (PICCs), and antimicrobial-coated PICCs have been introduced to minimize catheter-related infections. A decision-analytic cost-effectiveness model was developed from a societal perspective utilizing real-world data concerning PICC-related complications and costs from Class 3A hospitals and community hospital settings in China. The analysis compared the quality-adjusted life years (QALYs) for patients receiving antimicrobial-coated PICCs versus standard PICCs, with catheter-associated costs included. Incremental cost-effectiveness ratios (ICERs) were calculated in Chinese Yuan (¥) per QALY gained.Patients with antimicrobial-coated PICCs experienced slightly fewer complication-related events, leading to significantly lower costs for managing complications. In the Class 3A hospital setting, the average total cost per patient was lower with antimicrobial-coated PICCs (¥62,800) compared to standard PICCs (¥102,900), primarily due to reduced expenses for treating CLABSI and related unknown fever. The ICER demonstrated that the coated PICC was the dominant option, showing a negative ICER (cost-saving of approximately ¥4 million per QALY gained in the base-case Class 3A hospital scenario). In community hospital care scenarios, the cost advantage of antimicrobial-coated PICCs remained. Thus, the antimicrobial-coated PICC strategy was cost-saving, providing equal or improved health outcomes at lower costs in China's medical center and community hospital settings, making it a more efficient choice for long-term vascular access.