title: The use of indwelling pleural catheters for the management of malignant pleural effusion--direct costs in a Dutch hospital.
abstract: BACKGROUND
  Indwelling pleural catheters (IPCs) are increasingly used in the treatment of malignant pleural effusion (MPE). In general, these catheters have been reported to manage MPE efficiently. Unfortunately, insurance companies in the Netherlands do not reimburse these catheters in either first-line treatment or following failed talc pleurodesis.
  
  
  OBJECTIVE
  Investigation of direct costs of IPC placement.
  
  
  METHODS
  Retrospective analysis of a prospectively collected database. Direct costs for both catheters and vacuum bottles were calculated. Indicators for indirect costs such as adverse events and complications and the need for additional home care for drainage were registered.
  
  
  RESULTS
  Mean costs for IPC amounted to EUR 2,173 and were different between tumor types - mesothelioma: EUR 4,028, breast: EUR 2,204, lung: EUR 1,146 and other: EUR 1,841; p = 0.017. Four patients were admitted to hospital for treatment of complications. Mean costs for IPC placement was similar when inserted as frontline treatment and after failed pleurodesis. Approximately 75% of patients did not need any help from specialized home care.
  
  
  CONCLUSIONS
  Direct costs for IPC placement turn out to be acceptable when compared with estimated hospitalization costs for pleurodesis treatment. Randomized controlled trials have to be performed to compare the cost-effectiveness of IPCs compared to pleurodesis.
authors.affiliation: Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Rogier C
authors.initials: RC
authors.lastname: Boshuizen
authors.forename: Suzanne
authors.initials: S
authors.lastname: Onderwater
authors.forename: Sjaak J A
authors.initials: SJ
authors.lastname: Burgers
authors.forename: Michel M
authors.initials: MM
authors.lastname: van den Heuvel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000191:economics*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010994:Pleura; D016066:Pleural Effusion, Malignant / Q000191:economics* / Q000628:therapy*; D012189:Retrospective Studies