Limits...
A hospital cost analysis of a fibrin sealant patch in soft tissue and hepatic surgical bleeding

View Article: PubMed Central - PubMed

ABSTRACT

Background: Despite hemostat use, uncontrolled surgical bleeding is prevalent. Drawbacks of current hemostats include limitations with efficacy on first attempt and suboptimal ease-of-use. Evarrest® is a novel fibrin sealant patch that has demonstrated high hemostatic efficacy compared with standard of care across bleeding severities. The objective of this study was to conduct a hospital cost analysis of the fibrin sealant patch versus standard of care in soft tissue and hepatic surgical bleeding.

Methods: The analysis quantified the 30-day costs of each comparator from a hospital perspective. Published US unit costs were applied to resource use (ie, initial treatment, retreatment, operating time, hospitalization, transfusion, and ventilator) reported in four trials. A “surgical” analysis included resources clinically related to the hemostatic benefit of the fibrin sealant patch, whereas a “hospital” analysis included all resources reported in the trials. An exploratory subgroup analysis focused solely on coagulopathic patients defined by abnormal blood test results.

Results: The surgical analysis predicted cost savings of $54 per patient with the fibrin sealant patch compared with standard of care (net cost impact: −$54 per patient; sensitivity range: −$1,320 to $1,213). The hospital analysis predicted further cost savings with the fibrin sealant patch (net cost impact of −$2,846 per patient; sensitivity range: −$1,483 to −$5,575). Subgroup analyses suggest that the fibrin sealant patch may provide dramatic cost savings in the coagulopathic subgroup of $3,233 (surgical) and $9,287 (hospital) per patient. Results were most sensitive to operating time and product units.

Conclusion: In soft tissue and hepatic problematic surgical bleeding, the fibrin sealant patch may result in important hospital cost savings.

No MeSH data available.


Related in: MedlinePlus

Tornado diagrams for the cost per patient for the overall four-trial population.Notes: (A) Surgical analysis and (B) hospital analysis. Cost and resource inputs varied by either ±20% or ± SD. Negative numbers indicate cost savings.Abbreviations: SD, standard deviation; SoC, standard of care; OR, operating room.
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f2-ceor-8-507: Tornado diagrams for the cost per patient for the overall four-trial population.Notes: (A) Surgical analysis and (B) hospital analysis. Cost and resource inputs varied by either ±20% or ± SD. Negative numbers indicate cost savings.Abbreviations: SD, standard deviation; SoC, standard of care; OR, operating room.

Mentions: The model results were relatively robust to a number of variations in input values and assumptions. Figure 2A (surgical analysis) presents a tornado diagram where the input values were varied using standard deviations or by ±20%. For the surgical analysis, many of the results remained cost saving. In sensitivity scenarios where the fibrin sealant patch was not cost saving, nearly all results showed that its acquisition cost was at least partially offset with averted resource use. Results were particularly sensitive to the cost per minute of operating room time and the units of product used. Sensitivity analyses on the hospital analysis (Figure 2B) demonstrated that all results remained cost savings irrespective of the parameters varied. The amount of cost savings was particularly sensitive to variation around ventilator time, length of stay, and operating time.


A hospital cost analysis of a fibrin sealant patch in soft tissue and hepatic surgical bleeding
Tornado diagrams for the cost per patient for the overall four-trial population.Notes: (A) Surgical analysis and (B) hospital analysis. Cost and resource inputs varied by either ±20% or ± SD. Negative numbers indicate cost savings.Abbreviations: SD, standard deviation; SoC, standard of care; OR, operating room.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5036832&req=5

f2-ceor-8-507: Tornado diagrams for the cost per patient for the overall four-trial population.Notes: (A) Surgical analysis and (B) hospital analysis. Cost and resource inputs varied by either ±20% or ± SD. Negative numbers indicate cost savings.Abbreviations: SD, standard deviation; SoC, standard of care; OR, operating room.
Mentions: The model results were relatively robust to a number of variations in input values and assumptions. Figure 2A (surgical analysis) presents a tornado diagram where the input values were varied using standard deviations or by ±20%. For the surgical analysis, many of the results remained cost saving. In sensitivity scenarios where the fibrin sealant patch was not cost saving, nearly all results showed that its acquisition cost was at least partially offset with averted resource use. Results were particularly sensitive to the cost per minute of operating room time and the units of product used. Sensitivity analyses on the hospital analysis (Figure 2B) demonstrated that all results remained cost savings irrespective of the parameters varied. The amount of cost savings was particularly sensitive to variation around ventilator time, length of stay, and operating time.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Despite hemostat use, uncontrolled surgical bleeding is prevalent. Drawbacks of current hemostats include limitations with efficacy on first attempt and suboptimal ease-of-use. Evarrest® is a novel fibrin sealant patch that has demonstrated high hemostatic efficacy compared with standard of care across bleeding severities. The objective of this study was to conduct a hospital cost analysis of the fibrin sealant patch versus standard of care in soft tissue and hepatic surgical bleeding.

Methods: The analysis quantified the 30-day costs of each comparator from a hospital perspective. Published US unit costs were applied to resource use (ie, initial treatment, retreatment, operating time, hospitalization, transfusion, and ventilator) reported in four trials. A “surgical” analysis included resources clinically related to the hemostatic benefit of the fibrin sealant patch, whereas a “hospital” analysis included all resources reported in the trials. An exploratory subgroup analysis focused solely on coagulopathic patients defined by abnormal blood test results.

Results: The surgical analysis predicted cost savings of $54 per patient with the fibrin sealant patch compared with standard of care (net cost impact: −$54 per patient; sensitivity range: −$1,320 to $1,213). The hospital analysis predicted further cost savings with the fibrin sealant patch (net cost impact of −$2,846 per patient; sensitivity range: −$1,483 to −$5,575). Subgroup analyses suggest that the fibrin sealant patch may provide dramatic cost savings in the coagulopathic subgroup of $3,233 (surgical) and $9,287 (hospital) per patient. Results were most sensitive to operating time and product units.

Conclusion: In soft tissue and hepatic problematic surgical bleeding, the fibrin sealant patch may result in important hospital cost savings.

No MeSH data available.


Related in: MedlinePlus