Cost-effectiveness of taurolidine-citrate in a cohort of intestinal failure patients on home parenteral nutrition

• Published in: JPEN. Journal of parenteral and enteral nutrition 2023-12
• Main Authors: Williams, Thomas J, Moy, Naomi, Kaazan, Patricia, Callaghan, Gavin, Holtmann, Gerald, Martin, Neal
• Format: Article
• Language: English
• ISSN: 1941-2444

Catheter-related bloodstream infections in patients on home parenteral nutrition for chronic intestinal failure are associated with significant morbidity and financial costs. Taurolidine is associated with reduced bloodstream infections, with limited information on the cost-effectiveness as primary prevention. This study aimed to determine the cost-effectiveness of using taurolidine-citrate for the primary prevention of catheter-related bloodstream infections within a quaternary hospital. All patients with chronic intestinal failure with home parenteral nutrition were identified between January 2015 to November 2022. Data was retrospectively collected regarding patient demographics, home parenteral nutrition use, catheter-related bloodstream infection diagnosis and the use of taurolidine-citrate. The direct costs associated with catheter-related bloodstream infection-associated admissions and taurolidine-citrate use were obtained from the coding department using a bottom-up approach. An incremental cost-effective analysis was performed, with a time horizon of four years, to compare costs associated with primary and secondary prevention, with the outcome of cost per infection avoided. 44 patients received home parenteral nutrition within this period. The catheter-related bloodstream infection rates was 3.25 infections per 1,000 catheter days prior to the use of taurolidine-citrate and 0.35 infections per 1,000 catheter days following taurolidine-citrate use. Incremental cost effectiveness ratio indicates primary prevention is the weakly dominant intervention with the base case value of $27.04 per CRBSI avoided. This held with one-way sensitivity. Taurolidine-citrate in the primary prevention of catheter-related bloodstream infections in chronic intestinal failure patients on home parenteral nutrition is associated with reduced hospital costs and infection rates. This article is protected by copyright. All rights reserved.