Childhood Cancer

External catheters and PICC lines require supplies for cleaning, dressing, and irrigating the line, but a subcutaneous port does not. The port itself, however, is usually more costly than the external catheter and PICC line. The external catheter and the subcutaneous port require operating room time and the services of a surgeon and an anesthesiologist to insert them, but PICC lines are usually inserted in the hospital room by a doctor or nurse. External catheters can be removed in the clinic with only IV sedation, but subcutaneous ports can only be removed in the operating room. PICC lines are removed in the hospital room and require no sedation. A good rule of thumb to consider is that if an external catheter or subcutaneous port stays in place at least 6 months, the overall costs are almost equal (see comparison chart on next page).

Most insurance plans will cover the placement of any central venous catheter and the services of the surgeon, anesthesiologist, and operating room. Many plans, however, will not cover the cost of the supplies to maintain the line, and this can be an additional financial hardship for families.