Estimating the cost avoidance associated with a regional poison control center

Poison control centers (PCCs) play a pivotal role in managing toxicologic exposures, often preventing unnecessary healthcare utilization. However, comprehensive economic evaluations of individual PCCs that reflect post-COVID-19 pandemic care-seeking behaviors and current healthcare costs remain limited. The objective of this study was to estimate the healthcare cost avoidance associated with Pittsburgh's PCC consultation using real-world poison exposure data and a decision analytic model.

A cost-avoidance model was developed comparing clinical trajectories and costs for cases with and without PCC consultation. Patient pathways were informed by National Poison Data System (NPDS) records of calls managed by the Pittsburgh Poison Center (2020-2024), and cost inputs were drawn from the literature. A probability of trajectory change was applied to reflect uncertainty in the effectiveness of PCCs. An evidence-based hospital length-of-stay reduction of 11.7 hours from a published study was applied to relevant pathways. One-way and probabilistic sensitivity analyses were conducted, and scenario analyses explored assumptions for key model branches.

In the base case, the average healthcare cost per patient was $2,438 with PCC consultation and $3,975 without. Annual PCC operating costs were $2.74 million with 24,481 annual regional consults, resulting in a net annual cost avoidance of $34.87 million (95% credible interval: $34.62 million, $42.88 million), corresponding to a benefit-to-cost ratio of approximately 12.75:1 (a net return of $11.75 in avoided healthcare costs for every $1 spent on PCC operations). Sensitivity analysis identified patient behavior assumptions, specifically the likelihood of contacting a primary care provider or visiting the emergency department, as the most influential parameters.

PCC consultations were associated with substantial healthcare cost avoidance by averting unnecessary utilization and shortening hospital stays. By integrating real-world data and explicitly modeling counterfactual pathways, this analysis provides robust evidence supporting sustained investment in PCC infrastructure as a high-value public health intervention.