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Cost-Effectiveness Analysis of Safety-Engineered Devices

Published online by Cambridge University Press:  26 May 2016

Haruhisa Fukuda  and
Kensuke Moriwaki
Haruhisa Fukuda*
Affiliation:
Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Kensuke Moriwaki
Affiliation:
Department of Medical Statistics, Kobe Pharmaceutical University, Higashinada-ku, Kobe-shi, Hyogo, Japan
*
Address correspondence to Haruhisa Fukuda, MPH, PhD, Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582, Japan ([email protected]).
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Abstract

OBJECTIVE

To estimate the cost-effectiveness of safety-engineered devices (SEDs) relative to non-SEDs for winged steel needles, intravenous catheter stylets, suture needles, and insulin pen needles.

DESIGN

Decision analysis modeling.

PARTICIPANTS

Hypothetical cohort of healthcare workers who utilized needle devices.

METHODS

We developed a decision-analytic model to estimate and compare the life-cycle costs and benefits for SED and non-SED needle devices. For this cost-effectiveness analysis, we quantified the total direct medical cost per needlestick injury, number of needlestick injuries avoided, and incremental cost-effectiveness ratio. Sensitivity analyses were performed to examine the robustness of the base-case analysis.

RESULTS

In the base-case analysis, we calculated the incremental cost-effectiveness ratios of SED winged steel needles, intravenous catheter stylets, suture needles, and insulin pen needles to be $2,633, $13,943, $1,792, and $1,269 per needlestick injury avoided, respectively. Sensitivity analyses showed that the calculated incremental cost-effectiveness ratio values for using SEDs did not fall below zero even after adjusting the values of each parameter.

CONCLUSION

The use of SED needle devices would not produce cost savings for hospitals. Government intervention may be needed to systematically protect healthcare workers in Japan from the risk of bloodborne pathogen infections.

Infect Control Hosp Epidemiol 2016;37:1012–1021

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 9 , September 2016 , pp. 1012 - 1021
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

REFERENCES

1. Yoshikawa, T, Wada, K, Lee, JJ, et al. Incidence rate of needlestick and sharps injuries in 67 Japanese hospitals: a national surveillance study. PLOS ONE 2013;8:e77524.CrossRefGoogle ScholarPubMed
2. US Department of Labor, Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens; needlestick and other sharps injuries: final rule. Federal Register 2001;66:5317–5325.Google Scholar
3. Fukuda, H, Yamanaka, Y. Reducing needlestick injuries through safety-engineered devices: results of a Japanese multicenter study. J Hosp Infect 2016;92:147–153.CrossRefGoogle Scholar
4. Tosini, W, Ciotti, C, Goyer, F, et al. Needlestick injury rates according to different types of safety-engineered devices: results of a French multicenter study. Infect Control Hosp Epidemiol 2010;31:402–407.CrossRefGoogle ScholarPubMed
5. Fukuda, T, Shiroiwa, T, Ikeda, S, et al. Guideline for economic evaluation of healthcare technologies in Japan [in Japanese]. J Natl Inst Public Health 2013;62:625–640.Google Scholar
6. Ministry of Health, Labour and Welfare. Basic survey on wage structure [in Japanese]. 2015.Google Scholar
7. Mitsuda T, Atsumi Y, Kurosu H. Front-line therapy for diabetes and needlestick injuries [in Japanese]. Diabetes Today 2011;12:2–4.Google Scholar
8. Japan/EPINet Surveillance Working Group. The annual report 2013-2014 [in Japanese]. In: Program of the Annual Meeting of the Research Group for Occupational Infection Control and Prevention in Japan; May 31, 2014; Tokyo, Japan.Google Scholar
9. Workbook for designing, implementing and evaluating a sharps injury prevention program. Centers for Disease Control and Prevention website. http://www.cdc.gov/sharpssafety/pdf/sharpsworkbook_2008.pdf. Published 2008. Accessed December 15, 2015.Google Scholar
10. Nishino, K, Higuchil, K, Michino, J, et al. Anti-HCV prevalence in medical employees using different HCV antibody kits [in Japanese]. Japanese Journal of Transfusion Medicine 1992;38:636–639.Google Scholar
11. Hirao, T. Research on economic evaluations of various viral liver disease strategies [in Japanese]. Ministry of Health, Labour and Welfare Grant-in-Aid for Scientific Research (KAKENHI). Research project for practical applications in intractable diseases and cancer. 2014.Google Scholar
12. Sako, A, Yasunaga, H, Horiguchi, H, Hashimoto, H, Masaki, N, Matsuda, S. Acute hepatitis B in Japan: incidence, clinical practices and health policy. Hepatol Res 2011;41:39–45.CrossRefGoogle ScholarPubMed
13. Ito, K, Yotsuyanagi, H, Yatsuhashi, H, et al. Risk factors for long-term persistence of serum hepatitis B surface antigen following acute hepatitis B virus infection in Japanese adults. Hepatology 2014;59:89–97.CrossRefGoogle ScholarPubMed
14. Harris, A, Yong, K, Kermode, M. An economic evaluation of universal infant vaccination against hepatitis B virus using a combination vaccine (Hib-HepB): a decision analytic approach to cost effectiveness. Aust N Z J Public Health 2001;25:222–229.CrossRefGoogle ScholarPubMed
15. Fendrick, AM, Lee, JH, LaBarge, C, Glick, HA. Clinical and economic impact of a combination Haemophilus influenzae and hepatitis B vaccine: estimating cost-effectiveness using decision analysis. Arch Pediatr Adolesc Med 1999;153:126–136.CrossRefGoogle ScholarPubMed
16. Tilson, L, Thornton, L, O’Flanagan, D, Johnson, H, Barry, M. Cost effectiveness of hepatitis B vaccination strategies in Ireland: an economic evaluation. Eur J Public Health 2008;18:275–282.CrossRefGoogle ScholarPubMed
17. Goldstein, ST, Zhou, F, Hadler, SC, Bell, BP, Mast, EE, Margolis, HS. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int J Epidemiol 2005;34:1329–1339.CrossRefGoogle ScholarPubMed
18. Hung, HF, Chen, TH. Probabilistic cost-effectiveness analysis of the long-term effect of universal hepatitis B vaccination: an experience from Taiwan with high hepatitis B virus infection and hepatitis B e antigen positive prevalence. Vaccine 2009;27:6770–6776.CrossRefGoogle ScholarPubMed
19. Ikai, I, Kudo, M, Arii, S, et al. Report of the 18th follow-up survey of primary liver cancer in Japan. Hepatol Res 2010;40:1043–1059.CrossRefGoogle ScholarPubMed
20. Matsuo, J, Mizui, M, Okita, H, et al. Follow up of the 987 blood donors found with hepatitis C virus infection over 9-18 years. Hepatol Res 2012;42:637–647.CrossRefGoogle ScholarPubMed
21. Watanabe, H, Saito, T, Shinzawa, H, et al. Spontaneous elimination of serum hepatitis C virus (HCV) RNA in chronic HCV carriers: a population-based cohort study. J Med Virol 2003;71:56–61.CrossRefGoogle ScholarPubMed
22. Tanaka, J, Kumada, H, Ikeda, K, et al. Natural histories of hepatitis C virus infection in men and women simulated by the Markov model. J Med Virol 2003;70:378–386.CrossRefGoogle ScholarPubMed
23. Ikeda, K, Arase, Y, Saitoh, S, et al. Anticarcinogenic impact of interferon on patients with chronic hepatitis C: a large-scale long-term study in a single center. Intervirology 2006;49:82–90.CrossRefGoogle ScholarPubMed
24. Yatsuhashi, H, Yano, M. Natural history of chronic hepatitis C. J Gastroenterol Hepatol 2000;15:E111–E116.CrossRefGoogle ScholarPubMed
25. Toshikuni, N, Izumi, A, Nishino, K, et al. Comparison of outcomes between patients with alcoholic cirrhosis and those with hepatitis C virus-related cirrhosis. J Gastroenterol Hepatol 2009;24:1276–1283.CrossRefGoogle ScholarPubMed
26. Sangiovanni, A, Prati, GM, Fasani, P, et al. The natural history of compensated cirrhosis due to hepatitis C virus: a 17-year cohort study of 214 patients. Hepatology 2006;43:1303–1310.CrossRefGoogle ScholarPubMed
27. Hepatitis information center [in Japanese]. National Center for Global Health and Medicine website. http://www.kanen.ncgm.go.jp. Accessed December 15, 2015.Google Scholar
28. Averhoff, F, Mahoney, F, Coleman, P, Schatz, G, Hurwitz, E, Margolis, H. Immunogenicity of hepatitis B vaccines: implications for persons at occupational risk of hepatitis B virus infection. Am J Prev Med 1998;15:1–8.CrossRefGoogle ScholarPubMed
29. Laufer, FN, Chiarello, LA. Application of cost-effectiveness methodology to the consideration of needlestick-prevention technology. Am J Infect Control 1994;22:75–82.CrossRefGoogle Scholar
30. Roudot-Thoraval, F, Montagne, O, Schaeffer, A, Dubreuil-Lemaire, ML, Hachard, D, Durand-Zaleski, I. Costs and benefits of measures to prevent needlestick injuries in a university hospital. Infect Control Hosp Epidemiol 1999;20:614–617.CrossRefGoogle ScholarPubMed
31. Yassi, A, McGill, ML, Khokhar, JB. Efficacy and cost-effectiveness of a needleless intravenous access system. Am J Infect Control 1995;23:57–64.CrossRefGoogle ScholarPubMed
32. Glenngard, AH, Persson, U. Costs associated with sharps injuries in the Swedish health care setting and potential cost savings from needle-stick prevention devices with needle and syringe. Scand J Infect Dis 2009;41:296–302.CrossRefGoogle ScholarPubMed
33. National Institute of Infectious Diseases. HIV/AIDS 2014. Infectious Agents Surveillance Report 2015;36:165–166.Google Scholar
34. Department of Labor, Occupational Safety and Health Administration. 29 CFR §1910.1030. Occupational exposure to bloodborne pathogens; final rule. Fed Register 1991;56.Google Scholar