In the UK, the pressure on costs in the NHS has never been greater so it is important that for the launch of NGPOD we are able to demonstrate that NGPOD demonstrates value for money and preferably a more cost effective option for NG Tube position testing as an alternative to current methods. We have been reviewing the available health economic data in relation to current methods of testing for NGT position to give us a baseline to assess NGPOD against.
The costs of a test are far more than the test itself. A pH test strip for example costs approx. £0.07 and an X-ray £50-£70 depending on which NHS Trust you ask but these are only unit costs, they do not take into consideration the cost of the staff time, their grade, the other equipment involved.
To address the total standard fixed costs several factors, need to be considered and fortunately the discipline of Health Economics comes into play, using robust methodology and costs referenced from up to date sources and real-life resource demand data.
So, what are the actual costs of doing a pH Test or X-Ray? There are a couple of clinical papers that help us work this out….
The first study by Taylor et al1, published in 2014 and while it was not specifically designed to evaluate the costs of pH Testing and X-Rays this paper did include and analysis of the costs for these tests and concluded that a pH test costs £10.98 and an X-Ray £100 although the methodology for reaching this conclusion is not detailed within the paper.
The second and more recent paper by McFarland2 in 2016 was designed to, “evaluate the effectiveness of pH paper testing of aspirate and chest x-ray for determining nasogastric tube (NGT) placement in terms of cost and patient outcome”, and is therefore perhaps more suited to providing the baseline figures. In this paper the costs of a pH test are put at £43.20 and for X-ray £158.64 when all the associated costs are considered. The method of calculating these figures is explained in detail and therefore we will be able to use a similar method to evaluate the cost of NGPOD during clinical trials which should give us the data we need to build our value proposition to the NHS and beyond when NGPOD is launched.
1Taylor et al. BMC Health Services Research (2014) 14:648 DOI 10.1186/s12913-014-0648-4
2McFarland A. (2017) A cost utility analysis of the clinical algorithm for nasogastric tube placement confirmation in adult hospital patients. Journal of Advanced Nursing 73(1), 201–216. doi: 10.1111/jan.13103