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

Authors Corral M, Ferko N, Hogan A, Hollmann S, Gangoli G, Jamous N, Batiller J, Kocharian R

Received 14 May 2016

Accepted for publication 18 July 2016

Published 21 September 2016 Volume 2016:8 Pages 507—519

DOI https://doi.org/10.2147/CEOR.S112762

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Professor Giorgio Lorenzo Colombo

Mitra Corral,1 Nicole Ferko,2 Andrew Hogan,2 Sarah S Hollmann,2 Gaurav Gangoli,1 Nadine Jamous,3 Jonathan Batiller,1 Richard Kocharian1

1Ethicon BioSurgery, Somerville, NJ, USA; 2Cornerstone Research Group, Burlington, ON, Canada; 3Ethicon Biosurgery, Wokingham, Berkshire, UK

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.

Keywords: cost, soft tissue bleeding, hepatic bleeding, surgical bleeding, coagulopathic, fibrin sealant patch, hospital, health economics

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