BUDGET AND ENVIRONMENTAL IMPACT ANALYSIS OF MULTI-LAYER WATERTIGHT CLOSURE VERSUS CONVENTIONAL CLOSURE IN TOTAL JOINT ARTHROPLASTY IN SPAIN
Author(s)
Melek P. Bosut, MSc1, Hendramoorthy Maheswaran, MBBS, PhD2, Angela Motilla Peñarrubia, MSc3.
1Johnson & Johnson Medical GmbH, Norderstedt, Germany, 2Johnson & Johnson Medtech UK, Pinewood, United Kingdom, 3Johnson & Johnson S.A., Madrid, Spain.
1Johnson & Johnson Medical GmbH, Norderstedt, Germany, 2Johnson & Johnson Medtech UK, Pinewood, United Kingdom, 3Johnson & Johnson S.A., Madrid, Spain.
OBJECTIVES: Wound closure methods can affect rates of wound complications, which are linked to morbidity and costs. Clinical and US economic studies showed that multi-layer watertight closure (MLWC) including STRATAFIX™ Knotless Tissue Control Devices and DERMABOND® PRINEO® Skin Closure System reduced delayed healing, reoperations, hospital stay, and as well as healthcare costs. This study assesses the financial and environmental impact of implementing MLWC versus conventional closure (CC) in the Spanish setting.
METHODS: A decision tree model was constructed to estimate costs and environmental impact from a hospital perspective for a cohort of 100 patients undergoing total hip or knee arthroplasty. The analysis incorporated device acquisition costs and post-procedural resource use, including hospital length of stay, follow-up outpatient attendances, dressing utilisation, and 90-day reoperation rates. Data inputs were derived from Spanish administrative datasets, published studies, and national tariff sources. Cost outcomes were estimated over a 90-day time horizon and reported in 2026 Euros. Environmental impact was quantified using carbon dioxide equivalent (CO₂-eq) emissions. Parameter uncertainty was explored through deterministic and probabilistic sensitivity analyses.
RESULTS: Use of MLWC resulted in substantial cost reductions compared with CC, with estimated savings of €1,667 per patient. These results were consistent in probabilistic analyses (mean €1,664; 95% CrI: €1,432-€1,910), with all simulations favouring MLWC. Reductions in inpatient length of stay and lower reoperation rates were the main contributors to these savings. In addition, MLWC was associated with a decrease in environmental burden, corresponding to a reduction of 47 kg CO₂-eq per patient (95% CrI: 41-54).
CONCLUSIONS: In Spain, MLWC represents a potentially cost-saving and lower-emission alternative to conventional closure. Adoption of this approach may support both efficiency and sustainability objectives in orthopaedic care pathways.
METHODS: A decision tree model was constructed to estimate costs and environmental impact from a hospital perspective for a cohort of 100 patients undergoing total hip or knee arthroplasty. The analysis incorporated device acquisition costs and post-procedural resource use, including hospital length of stay, follow-up outpatient attendances, dressing utilisation, and 90-day reoperation rates. Data inputs were derived from Spanish administrative datasets, published studies, and national tariff sources. Cost outcomes were estimated over a 90-day time horizon and reported in 2026 Euros. Environmental impact was quantified using carbon dioxide equivalent (CO₂-eq) emissions. Parameter uncertainty was explored through deterministic and probabilistic sensitivity analyses.
RESULTS: Use of MLWC resulted in substantial cost reductions compared with CC, with estimated savings of €1,667 per patient. These results were consistent in probabilistic analyses (mean €1,664; 95% CrI: €1,432-€1,910), with all simulations favouring MLWC. Reductions in inpatient length of stay and lower reoperation rates were the main contributors to these savings. In addition, MLWC was associated with a decrease in environmental burden, corresponding to a reduction of 47 kg CO₂-eq per patient (95% CrI: 41-54).
CONCLUSIONS: In Spain, MLWC represents a potentially cost-saving and lower-emission alternative to conventional closure. Adoption of this approach may support both efficiency and sustainability objectives in orthopaedic care pathways.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE269
Topic
Economic Evaluation, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Surgery