Surgical Stripping and Ligation Compared to Cyanoacrylate Vein Closure in the Mexican Public Healthcare Setting: Direct Costs and Incapacity Pay
Author(s)
Kyla Jones, MSc1, JUAN VALENCIA, MSc, MD2, Alejandra González De La Vega, MD3;
1Medtronic, CMDX, Mexico, 2Medtronic, Miami, FL, USA, 3Medtronic, CDMX, Mexico
1Medtronic, CMDX, Mexico, 2Medtronic, Miami, FL, USA, 3Medtronic, CDMX, Mexico
OBJECTIVES: In Mexico, social security institutes cover healthcare, unemployment, and incapacity, making incapacity pay a key factor in healthcare decisions. Surgical Stripping and Ligation (SSL), the current standard treatment for Chronic Venous Insufficiency (CVI), incurs high direct costs and prolonged recovery times. Cyanoacrylate Closure (CAC) has higher product costs but significantly reduces recovery time. This study compared SSL and CAC in the Mexican public healthcare setting by evaluating direct medical costs and incapacity pay.
METHODS: A cost calculator was developed to compare SSL and CAC costs across various scenarios. Direct costs were sourced from the 2024 Mexican Institute of Social Security (IMSS) unitary costs (third-level care), and Diagnosis-Related Groups (DRGs). The base case scenario of direct costs used unitary costs, considering overhead, hospitalization days, specialist consultations, and consumables; alternative scenarios incorporated the SSL DRG adjusted to 2024 costs. Incapacity pay was estimated using IMSS regulations, recovery days, and an average daily salary derived from national minimum and maximum IMSS allowances. Recovery days for the base case were sourced from literature, with alternative inputs from IMSS hospital sources. Results were tested across scenarios for robustness.
RESULTS: In a base case, SLL is 3.6 times more costly than CAC, with incapacity pay accounting for 17% of SLL costs, and for up to 30% in the most extreme scenarios. In the most expensive scenario for CAC, assuming its use in a surgical room, CAC was 1.4 times costlier than SLL. The cost-saving trends of CAC persisted across other variations in costs, hospitalization days, consultations and recovery times, driven by CAC's outpatient nature and shorter recovery period.
CONCLUSIONS: In the Mexican healthcare system, where incapacity is covered by healthcare providing institutes, CAC offers a cost-saving alternative to SSL, freeing surgical rooms and reducing patient recovery time. These results align with international evidence.
METHODS: A cost calculator was developed to compare SSL and CAC costs across various scenarios. Direct costs were sourced from the 2024 Mexican Institute of Social Security (IMSS) unitary costs (third-level care), and Diagnosis-Related Groups (DRGs). The base case scenario of direct costs used unitary costs, considering overhead, hospitalization days, specialist consultations, and consumables; alternative scenarios incorporated the SSL DRG adjusted to 2024 costs. Incapacity pay was estimated using IMSS regulations, recovery days, and an average daily salary derived from national minimum and maximum IMSS allowances. Recovery days for the base case were sourced from literature, with alternative inputs from IMSS hospital sources. Results were tested across scenarios for robustness.
RESULTS: In a base case, SLL is 3.6 times more costly than CAC, with incapacity pay accounting for 17% of SLL costs, and for up to 30% in the most extreme scenarios. In the most expensive scenario for CAC, assuming its use in a surgical room, CAC was 1.4 times costlier than SLL. The cost-saving trends of CAC persisted across other variations in costs, hospitalization days, consultations and recovery times, driven by CAC's outpatient nature and shorter recovery period.
CONCLUSIONS: In the Mexican healthcare system, where incapacity is covered by healthcare providing institutes, CAC offers a cost-saving alternative to SSL, freeing surgical rooms and reducing patient recovery time. These results align with international evidence.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE480
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)