Health Economic Aspects of Platelet Concentrates: Comparing Cost and Reimbursement of Pathogen Inactivated and Conventional Platelet Concentrates in a German Comprehensive Cancer Center

Bonn, Jennifer
Baltin, Christoph T.
Osterkamp, Viola
Scheid, Christof
Holtick, Udo
Irsch, Johannes
Kron, Florian

^aVITIS Healthcare Group, Cologne, Germany
^bClinic and Polyclinic for Orthopaedics and Trauma Surgery, University Hospital of Cologne, Cologne, Germany
^cCompetence Center for Medical Economics, FOM University of Applied Sciences, Essen, Germany
^dDepartment I of Internal Medicine, Center of Integrated Oncology Aachen Bonn Cologne Duesseldorf, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
^eCerus Europe B.V., Amersfoort, The Netherlands

Correspondence to: Florian Kron, [email protected]

Received: December 22, 2022

Accepted: June 19, 2023

Published online: July 21, 2023

Oncology Research and Treatment 46(9):p 362-369, September 2023. | DOI: 10.1159/000531742

Abstract

Introduction:

Pathogen inactivation (PI) utilizing amotosalen and UVA light (INTERCEPT^® Blood System) is a well-established method for the production of safer platelet concentrates (PCs). While many studies describe clinical and logistical benefits of PI, the implications and potential challenges from a hospital management perspective have not yet been analyzed - health economic analyses considering reimbursement of PI are lacking. The objective of this analysis was to examine the real-life inpatient treatment costs from a hospital perspective and to assess the economic impact of PI-PC versus conventional PC (CONV-PC) administration in Germany.

Methods:

Real-life cost data for inpatient cancer cases from 2020 of the University Hospital Cologne were identified by operating and procedure codes. The German diagnosis-related groups, extra fees, case mix index (CMI), length of stay (LOS), and average resource consumption of PC were evaluated from a micro-management perspective. The potential economic impact of implementing PI-treated PCs was modeled retrospectively.

Results:

In total, 951 inpatient cases were analyzed (CMI [median 4.7-9.9], LOS [median 26 days], number of cases in intensive care units [38%]). The median DRG fee was between EUR 13,800 and EUR 26,400. According to our model, the use of PI-PC compared to CONV-PC would result in savings between EUR 184 and EUR 306 per case.

Conclusion:

From a hospital management perspective, oncological cases requiring PC transfusion are associated with a high CMI (reimbursement per DRG flat fee) and moderate costs with sufficient add-on payment for PI on a case level. Investment and process costs for PI implementation can be analyzed for site-specific scenarios.