Abstract
Introduction
Pressurized Intraperitoneal Aerosol chemotherapy (PIPAC) is a new surgical technique
for the treatment of unresectable peritoneal carcinomatosis. Very little data is available
on the costs of this treatment in France as there is currently no code for PIPAC in
the French Common Classification of Medical Acts (CCAM). Our objective was to estimate
the mean cost of hospitalization for PIPAC in two French public teaching hospitals.
Methods
The mean cost of hospitalization was estimated from the mean fixed-rate remuneration
paid to the hospital and the mean additional costs of treatment paid by the hospital.
At discharge a patient's hospitalization is classified into a diagnosis related group,
which determines the fixed-rate remuneration paid to the hospital (obtained from the
national hospitals database - PMSI). Costs of medical devices and drug treatments
specific to PIPAC, not covered by the fixed-rate remuneration, were obtained from
the hospital pharmacies.
Results
Between July 2016 and November 2021, 205 PIPAC procedures were performed on 79 patients
(mean procedures per patient = 2.6). Mean operating room occupancy was 165 min. The
mean fixed-rate remuneration received by the hospitals per PIPAC hospitalization was
€4031. The actual mean cost per hospitalization was €6562 for a mean length-of-stay
of 3.3 days. Thus, each PIPAC hospitalization cost the hospital €2531 on average.
Conclusion
The current reimbursement of PIPAC treatment by the national health system is insufficient
and represents only 61% of the real cost. The creation of a new fixed-rate remuneration
for PIPAC taking into account this cost differential is necessary.
Keywords
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Article info
Publication history
Published online: August 07, 2022
Accepted:
July 31,
2022
Received in revised form:
July 21,
2022
Received:
June 8,
2022
Identification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
