Research Article
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Published Online: 16 July 2021

Cost Effectiveness of Malignant Pleural Effusion with Indwelling Catheter: Systematic Review

Publication: Journal of Palliative Medicine
Volume 24, Issue Number 8

Abstract

Background: The current cost of treatment of malignant pleural effusion (MPE) with an indwelling pleural catheter (IPC) is unclear.
Objective: We propose a review of the scientific evidence on the cost and effectiveness of this therapeutic option.
Methods: Systematic review of the literature on the cost and effectiveness of the treatment of MPE by IPC, according to the PRISMA methodology and quality according to the scientific guidelines.
Results: A total of 4 articles, 152 patients, and 159 IPCs were included. The use of IPC was associated with improvement in symptoms and quality of life. The most common complications were infections (empyema in 20.9% of patients and cellulitis in 17.3%); 9% of cases were hospitalized due to complications, and <2% required subsequent procedures. The average cost of IPC (set/drainage bottles) ranged from €2,025.6 to €1,200.5 if it was placed on an outpatient basis, €1,100 if survival was <6 weeks, and €4,028 in patients with mesothelioma. Complications increased the cost, and taking into account follow-up visits, additional tests, and days of admission for complications, the cost was >€5,000. Compared with pleurodesis, the cost of IPC was significantly lower when patient survival was <14 weeks, but not when survival was longer or home care was required.
Conclusions: The use of IPC is associated with good control of MPE and seldom requires many subsequent procedures; however, it is also associated with a certain rate of complications, which may increase costs. However, ambulatory management may help reduce costs, which are directly related to the type of tumor, the duration of survival, and the need for specialized treatment.

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References

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Published In

cover image Journal of Palliative Medicine
Journal of Palliative Medicine
Volume 24Issue Number 8August 2021
Pages: 1206 - 1212
PubMed: 33395352

History

Published in print: August 2021
Published online: 16 July 2021
Published ahead of print: 30 December 2020
Accepted: 3 December 2020

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Maribel Botana-Rial [email protected]
Pulmonary Department, Hospital Álvaro Cunqueiro, Vigo, Spain.
PneumoVigoI+I Research Group, Sanitary Research Institute Galicia Sur (IIS Galicia Sur), Vigo, Spain.
Cristina Ramos-Hernández
Pulmonary Department, Hospital Álvaro Cunqueiro, Vigo, Spain.
PneumoVigoI+I Research Group, Sanitary Research Institute Galicia Sur (IIS Galicia Sur), Vigo, Spain.
Irene Lojo-Rodríguez
Pulmonary Department, Hospital Álvaro Cunqueiro, Vigo, Spain.
PneumoVigoI+I Research Group, Sanitary Research Institute Galicia Sur (IIS Galicia Sur), Vigo, Spain.
Cristina Represas-Represas
Pulmonary Department, Hospital Álvaro Cunqueiro, Vigo, Spain.
PneumoVigoI+I Research Group, Sanitary Research Institute Galicia Sur (IIS Galicia Sur), Vigo, Spain.
Alberto Ruano-Raviña
Deparment of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
Consortium for Biomedical Research in Epidemiologic and Public Health (CIBER en Epidemiologia y Salúd Pública—CIBERESP), Madrid, Spain.
Virginia Leiro-Fernández
Pulmonary Department, Hospital Álvaro Cunqueiro, Vigo, Spain.
PneumoVigoI+I Research Group, Sanitary Research Institute Galicia Sur (IIS Galicia Sur), Vigo, Spain.
Alberto Fernández-Villar
Pulmonary Department, Hospital Álvaro Cunqueiro, Vigo, Spain.
PneumoVigoI+I Research Group, Sanitary Research Institute Galicia Sur (IIS Galicia Sur), Vigo, Spain.

Notes

Address correspondence to: Maribel Botana-Rial, PhD, Pulmonary Department, Hospital Álvaro Cunqueiro, Clara Campoamor 341, Vigo 36312, Spain [email protected]

Authors' Contributions

Conception and design: M.B.-R., C.R.-H. Administrative support: V.L.-F., A.F.-V. Provision of study materials or patients: M.B.-R., C.R.-H., I.L.-R., C.R.-R. Collection and assembly of data: M.B.-R., C.R.-H., I.L.-R., C.R.-R. Data analysis and interpretation: M.B.-R., C.R.-H., A.R.-R. Article writing: All authors. Final approval of article: All authors.

Author Disclosure Statement

No competing financial interests exist.

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No funding was received for this article.

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