4 YEAR COST-ANALYSIS OF AUTOMATED RED CELL EXCHANGE TRANSFUSION FOR MANAGEMENT OF RECURRENT PAINFUL CRISES IN ADULT PATIENTS WITH SICKLE CELL DISEASE
(Abstract release date: 05/19/16)
EHA Library. Tsitsikas D. 06/09/16; 133031; E1482
Dr. Dimitris Tsitsikas
Contributions
Contributions
Abstract
Abstract: E1482
Type: Eposter Presentation
Background
Automated red cell exchange transfusion (ARCET) is a promising modality in treating chronic complications in sickle cell disease (SCD). However, concerns around the cost of the procedure may limit its adoption in some institutions.
Aims
To assess the cost implications / financial gains of regular ARCET for SCD patients who have been on the programme for 4 years for recurrent pain in our institution.
Methods
We adopted ARCET in our institution in June 2011 and 8 patients have been on the programme for 4 consecutive years for management of recurrent painful crises. Data were collected retrospectively and the hospital attendance of these patients one year prior to the intervention (as a comparator) and every year after starting ARCET were analysed. Prices for different aspects of the service were provided by the divisional operational manager of the department and the haematology laboratory manager and were as follows: Haematology day unit unplanned attendance: £1022, emergency department (ED) attendance: £235, in-patient stay up to 8 days: £1540 and in-patient stays in excess of 8 days: £1540 + £294 / every day in excess of 8. The total cost of blood over these 4 years was £309,200, the cost of using the day unit for the procedures £218,400 and the cost of the consumables used £36,839 giving a total cost of £564,439 for the 4 years. Cost of hospital attendance without the intervention was projected over 4 years based on the hospital attendance the year prior to commencing the intervention.
Results
1) Total day unit unplanned attendance (without admission): 222 days one year prior to intervention, projected 888 over 4 years with projected cost £907,536. Attendance after intervention was 103, 142, 78 and 37 days 1, 2, 3 and 4 years post intervention respectively with a total of 360 days in 4 years and an actual cost of £367,920 and a 4 yr projected cost reduction of £539,616. 2) Total ED attendance (without admission): 173 days one year prior to intervention, projected 692 over 4 years with projected cost £162,620. Attendance after intervention was 130, 86, 72 and 53 days 1, 2, 3 and 4 years post intervention respectively with a total of 341 days in 4 years and an actual cost of £80,135 and a 4 yr projected cost reduction of £82,485. 3) Total in-patient episodes up to 8 days: 42 one year prior to intervention, projected 168 over 4 years with projected cost £258,720. Episodes after intervention were 48, 31, 37 and 32 1, 2, 3 and 4 years post intervention respectively with a total of 148 episodes in 4 years and an actual cost of £227,920 and a 4 yr projected cost reduction of £30,800. 4) Total in-patient episodes in excess of 8 days: 26 one year prior to intervention, projected 104 over 4 years with projected cost £160,160. Episodes after intervention were 11, 13, 10 and 11 1, 2, 3 and 4 years post intervention respectively with a total of 45 episodes in 4 years and an actual cost of £69,300 and a 4 yr projected cost reduction of £90,860. 5) In-patients days in excess of 8: 485 days one year prior to intervention, projected 1940 over 4 years with projected cost £570,360. In-patient days in excess of 8 after intervention were 73, 138, 57 and 86 days 1, 2, 3 and 4 years post intervention respectively with a total of 354 days in 4 years and an actual cost of £104,076 and a 4 yr projected cost reduction of £466,284. Overall, cost was £564,439 with projected savings of 1,210,045 and a 4y projected cost benefit of £645,606.
Conclusion
ARCET appears cost-effective for management of recurrent pain in SCD in the medium-long term.
Session topic: E-poster
Keyword(s): Cost analysis, Sickle cell disease, Transfusion
Type: Eposter Presentation
Background
Automated red cell exchange transfusion (ARCET) is a promising modality in treating chronic complications in sickle cell disease (SCD). However, concerns around the cost of the procedure may limit its adoption in some institutions.
Aims
To assess the cost implications / financial gains of regular ARCET for SCD patients who have been on the programme for 4 years for recurrent pain in our institution.
Methods
We adopted ARCET in our institution in June 2011 and 8 patients have been on the programme for 4 consecutive years for management of recurrent painful crises. Data were collected retrospectively and the hospital attendance of these patients one year prior to the intervention (as a comparator) and every year after starting ARCET were analysed. Prices for different aspects of the service were provided by the divisional operational manager of the department and the haematology laboratory manager and were as follows: Haematology day unit unplanned attendance: £1022, emergency department (ED) attendance: £235, in-patient stay up to 8 days: £1540 and in-patient stays in excess of 8 days: £1540 + £294 / every day in excess of 8. The total cost of blood over these 4 years was £309,200, the cost of using the day unit for the procedures £218,400 and the cost of the consumables used £36,839 giving a total cost of £564,439 for the 4 years. Cost of hospital attendance without the intervention was projected over 4 years based on the hospital attendance the year prior to commencing the intervention.
Results
1) Total day unit unplanned attendance (without admission): 222 days one year prior to intervention, projected 888 over 4 years with projected cost £907,536. Attendance after intervention was 103, 142, 78 and 37 days 1, 2, 3 and 4 years post intervention respectively with a total of 360 days in 4 years and an actual cost of £367,920 and a 4 yr projected cost reduction of £539,616. 2) Total ED attendance (without admission): 173 days one year prior to intervention, projected 692 over 4 years with projected cost £162,620. Attendance after intervention was 130, 86, 72 and 53 days 1, 2, 3 and 4 years post intervention respectively with a total of 341 days in 4 years and an actual cost of £80,135 and a 4 yr projected cost reduction of £82,485. 3) Total in-patient episodes up to 8 days: 42 one year prior to intervention, projected 168 over 4 years with projected cost £258,720. Episodes after intervention were 48, 31, 37 and 32 1, 2, 3 and 4 years post intervention respectively with a total of 148 episodes in 4 years and an actual cost of £227,920 and a 4 yr projected cost reduction of £30,800. 4) Total in-patient episodes in excess of 8 days: 26 one year prior to intervention, projected 104 over 4 years with projected cost £160,160. Episodes after intervention were 11, 13, 10 and 11 1, 2, 3 and 4 years post intervention respectively with a total of 45 episodes in 4 years and an actual cost of £69,300 and a 4 yr projected cost reduction of £90,860. 5) In-patients days in excess of 8: 485 days one year prior to intervention, projected 1940 over 4 years with projected cost £570,360. In-patient days in excess of 8 after intervention were 73, 138, 57 and 86 days 1, 2, 3 and 4 years post intervention respectively with a total of 354 days in 4 years and an actual cost of £104,076 and a 4 yr projected cost reduction of £466,284. Overall, cost was £564,439 with projected savings of 1,210,045 and a 4y projected cost benefit of £645,606.
Conclusion
ARCET appears cost-effective for management of recurrent pain in SCD in the medium-long term.
Session topic: E-poster
Keyword(s): Cost analysis, Sickle cell disease, Transfusion
Abstract: E1482
Type: Eposter Presentation
Background
Automated red cell exchange transfusion (ARCET) is a promising modality in treating chronic complications in sickle cell disease (SCD). However, concerns around the cost of the procedure may limit its adoption in some institutions.
Aims
To assess the cost implications / financial gains of regular ARCET for SCD patients who have been on the programme for 4 years for recurrent pain in our institution.
Methods
We adopted ARCET in our institution in June 2011 and 8 patients have been on the programme for 4 consecutive years for management of recurrent painful crises. Data were collected retrospectively and the hospital attendance of these patients one year prior to the intervention (as a comparator) and every year after starting ARCET were analysed. Prices for different aspects of the service were provided by the divisional operational manager of the department and the haematology laboratory manager and were as follows: Haematology day unit unplanned attendance: £1022, emergency department (ED) attendance: £235, in-patient stay up to 8 days: £1540 and in-patient stays in excess of 8 days: £1540 + £294 / every day in excess of 8. The total cost of blood over these 4 years was £309,200, the cost of using the day unit for the procedures £218,400 and the cost of the consumables used £36,839 giving a total cost of £564,439 for the 4 years. Cost of hospital attendance without the intervention was projected over 4 years based on the hospital attendance the year prior to commencing the intervention.
Results
1) Total day unit unplanned attendance (without admission): 222 days one year prior to intervention, projected 888 over 4 years with projected cost £907,536. Attendance after intervention was 103, 142, 78 and 37 days 1, 2, 3 and 4 years post intervention respectively with a total of 360 days in 4 years and an actual cost of £367,920 and a 4 yr projected cost reduction of £539,616. 2) Total ED attendance (without admission): 173 days one year prior to intervention, projected 692 over 4 years with projected cost £162,620. Attendance after intervention was 130, 86, 72 and 53 days 1, 2, 3 and 4 years post intervention respectively with a total of 341 days in 4 years and an actual cost of £80,135 and a 4 yr projected cost reduction of £82,485. 3) Total in-patient episodes up to 8 days: 42 one year prior to intervention, projected 168 over 4 years with projected cost £258,720. Episodes after intervention were 48, 31, 37 and 32 1, 2, 3 and 4 years post intervention respectively with a total of 148 episodes in 4 years and an actual cost of £227,920 and a 4 yr projected cost reduction of £30,800. 4) Total in-patient episodes in excess of 8 days: 26 one year prior to intervention, projected 104 over 4 years with projected cost £160,160. Episodes after intervention were 11, 13, 10 and 11 1, 2, 3 and 4 years post intervention respectively with a total of 45 episodes in 4 years and an actual cost of £69,300 and a 4 yr projected cost reduction of £90,860. 5) In-patients days in excess of 8: 485 days one year prior to intervention, projected 1940 over 4 years with projected cost £570,360. In-patient days in excess of 8 after intervention were 73, 138, 57 and 86 days 1, 2, 3 and 4 years post intervention respectively with a total of 354 days in 4 years and an actual cost of £104,076 and a 4 yr projected cost reduction of £466,284. Overall, cost was £564,439 with projected savings of 1,210,045 and a 4y projected cost benefit of £645,606.
Conclusion
ARCET appears cost-effective for management of recurrent pain in SCD in the medium-long term.
Session topic: E-poster
Keyword(s): Cost analysis, Sickle cell disease, Transfusion
Type: Eposter Presentation
Background
Automated red cell exchange transfusion (ARCET) is a promising modality in treating chronic complications in sickle cell disease (SCD). However, concerns around the cost of the procedure may limit its adoption in some institutions.
Aims
To assess the cost implications / financial gains of regular ARCET for SCD patients who have been on the programme for 4 years for recurrent pain in our institution.
Methods
We adopted ARCET in our institution in June 2011 and 8 patients have been on the programme for 4 consecutive years for management of recurrent painful crises. Data were collected retrospectively and the hospital attendance of these patients one year prior to the intervention (as a comparator) and every year after starting ARCET were analysed. Prices for different aspects of the service were provided by the divisional operational manager of the department and the haematology laboratory manager and were as follows: Haematology day unit unplanned attendance: £1022, emergency department (ED) attendance: £235, in-patient stay up to 8 days: £1540 and in-patient stays in excess of 8 days: £1540 + £294 / every day in excess of 8. The total cost of blood over these 4 years was £309,200, the cost of using the day unit for the procedures £218,400 and the cost of the consumables used £36,839 giving a total cost of £564,439 for the 4 years. Cost of hospital attendance without the intervention was projected over 4 years based on the hospital attendance the year prior to commencing the intervention.
Results
1) Total day unit unplanned attendance (without admission): 222 days one year prior to intervention, projected 888 over 4 years with projected cost £907,536. Attendance after intervention was 103, 142, 78 and 37 days 1, 2, 3 and 4 years post intervention respectively with a total of 360 days in 4 years and an actual cost of £367,920 and a 4 yr projected cost reduction of £539,616. 2) Total ED attendance (without admission): 173 days one year prior to intervention, projected 692 over 4 years with projected cost £162,620. Attendance after intervention was 130, 86, 72 and 53 days 1, 2, 3 and 4 years post intervention respectively with a total of 341 days in 4 years and an actual cost of £80,135 and a 4 yr projected cost reduction of £82,485. 3) Total in-patient episodes up to 8 days: 42 one year prior to intervention, projected 168 over 4 years with projected cost £258,720. Episodes after intervention were 48, 31, 37 and 32 1, 2, 3 and 4 years post intervention respectively with a total of 148 episodes in 4 years and an actual cost of £227,920 and a 4 yr projected cost reduction of £30,800. 4) Total in-patient episodes in excess of 8 days: 26 one year prior to intervention, projected 104 over 4 years with projected cost £160,160. Episodes after intervention were 11, 13, 10 and 11 1, 2, 3 and 4 years post intervention respectively with a total of 45 episodes in 4 years and an actual cost of £69,300 and a 4 yr projected cost reduction of £90,860. 5) In-patients days in excess of 8: 485 days one year prior to intervention, projected 1940 over 4 years with projected cost £570,360. In-patient days in excess of 8 after intervention were 73, 138, 57 and 86 days 1, 2, 3 and 4 years post intervention respectively with a total of 354 days in 4 years and an actual cost of £104,076 and a 4 yr projected cost reduction of £466,284. Overall, cost was £564,439 with projected savings of 1,210,045 and a 4y projected cost benefit of £645,606.
Conclusion
ARCET appears cost-effective for management of recurrent pain in SCD in the medium-long term.
Session topic: E-poster
Keyword(s): Cost analysis, Sickle cell disease, Transfusion
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