Cost-Effectiveness Evaluation of Chlorhexidine Coated vs. Standard Peripherally Inserted Central Catheters (PICCs)

Peripherally inserted central catheters (PICCs) play a crucial role in providing long-term intravenous therapy for patients requiring extended vascular access. With multiple PICC types available, understanding their cost-effectiveness is essential for healthcare decisions that balance clinical benefits with economic considerations. This study assesses the economic and clinical outcomes of chlorhexidine-coated PICCs (Type A) versus standard PICCs (Type B), aiming to guide best practices in vascular access by addressing the gap in comprehensive cost-effectiveness comparisons. Using a decision-analytic model, costs and quality-adjusted life years (QALYs) between the two types were compared. Primary data from five Chinese university-affiliated medical centers were gathered from 2020 to 2023, with a Delphi panel validating the model inputs. The analysis revealed that while Type A PICCs offer lower initial placement costs, they incur higher complication rates compared to Type B PICCs, which influences long-term cost-effectiveness. After adjusting for complication rates and QALYs, Type B PICCs emerged as more cost-effective over a one-year period, with an incremental cost-effectiveness ratio (ICER) of ¥-40,043.78 ($5,905.90, average exchange rate ¥678.03=$100) per QALY gained. Although Type B PICCs have higher initial costs, their lower complication rates make them a more valuable option for long-term vascular access, offering better overall cost-efficiency.