COST-EFFECTIVENESS AND BUDGET IMPACT OF A SURGICAL SEALANT FOR THE PREVENTION OF POST-SURGICAL ADHESIONS IN GYNECOLOGIC SURGERY IN MEXICO
Author(s)
Tamara Rodríguez Cruz, BEc1, Montserrat Galindo Alvarado, Master2, Humberto Maciel, MD3, Jonathan Diaz, Jr., Lic.4.
1Baxter Healthcare, CDMX, Mexico, 2Baxter Healthcare, Mexico City, Mexico, 3TECNOLOGÍA E INFORMÁTICA PARA LA SALUD S.A. DE C.V., Mexico City, Mexico, 4Tecnología e información para la salud (T.I. Salud), Mexico City, Mexico.
1Baxter Healthcare, CDMX, Mexico, 2Baxter Healthcare, Mexico City, Mexico, 3TECNOLOGÍA E INFORMÁTICA PARA LA SALUD S.A. DE C.V., Mexico City, Mexico, 4Tecnología e información para la salud (T.I. Salud), Mexico City, Mexico.
OBJECTIVES: Post-surgical adhesions are a frequent complication of gynecologic surgery and are associated with chronic pelvic pain, infertility, intestinal obstruction, and increased complexity of future surgical procedures. Preventive strategies may reduce these complications and their associated healthcare costs. This study assessed the cost-effectiveness and budget impact of a surgical sealant compared with standard surgical closure without adhesion barriers in women undergoing gynecologic surgery, particularly myomectomy, from the perspective of Mexican public hospitals.
METHODS: A systematic literature review was conducted to identify evidence on the effectiveness and safety of the surgical sealant for adhesion prevention. A decision-tree model was developed to estimate post-surgical adhesion prevention, related complications, and associated costs following gynecologic surgery. Clinical inputs were primarily obtained from a randomized controlled trial in myomectomy patients. Costs were estimated using Diagnosis-Related Groups (DRGs) and healthcare resource utilization associated with adhesion-related complications. Deterministic and probabilistic sensitivity analyses were performed to assess parameter uncertainty. A five-year budget impact analysis evaluated the financial implications of gradual adoption in Mexican public hospitals.
RESULTS: The surgical sealant was associated with lower expected costs ($123,424.00 MXN vs. $133,907.00 MXN) and a higher probability of adhesion prevention (65.8% vs. 35.0%) compared with standard care. Incremental cost was -$10,483.00 MXN with an incremental effectiveness of 30.8%, resulting in an incremental cost-effectiveness ratio of -$34,035.00 MXN indicating that the intervention was dominant. Sensitivity analyses consistently supported the robustness of the base-case findings across multiple scenarios. The budget impact analysis estimated cumulative savings of approximately MXN $16 billion over five years with gradual adoption.
CONCLUSIONS: The surgical sealant appears to be a cost-saving and more effective strategy for preventing post-surgical adhesions following gynecologic surgery compared with standard closure methods. Gradual adoption in Mexican public hospitals could improve clinical outcomes while generating substantial savings for the public healthcare system.
METHODS: A systematic literature review was conducted to identify evidence on the effectiveness and safety of the surgical sealant for adhesion prevention. A decision-tree model was developed to estimate post-surgical adhesion prevention, related complications, and associated costs following gynecologic surgery. Clinical inputs were primarily obtained from a randomized controlled trial in myomectomy patients. Costs were estimated using Diagnosis-Related Groups (DRGs) and healthcare resource utilization associated with adhesion-related complications. Deterministic and probabilistic sensitivity analyses were performed to assess parameter uncertainty. A five-year budget impact analysis evaluated the financial implications of gradual adoption in Mexican public hospitals.
RESULTS: The surgical sealant was associated with lower expected costs ($123,424.00 MXN vs. $133,907.00 MXN) and a higher probability of adhesion prevention (65.8% vs. 35.0%) compared with standard care. Incremental cost was -$10,483.00 MXN with an incremental effectiveness of 30.8%, resulting in an incremental cost-effectiveness ratio of -$34,035.00 MXN indicating that the intervention was dominant. Sensitivity analyses consistently supported the robustness of the base-case findings across multiple scenarios. The budget impact analysis estimated cumulative savings of approximately MXN $16 billion over five years with gradual adoption.
CONCLUSIONS: The surgical sealant appears to be a cost-saving and more effective strategy for preventing post-surgical adhesions following gynecologic surgery compared with standard closure methods. Gradual adoption in Mexican public hospitals could improve clinical outcomes while generating substantial savings for the public healthcare system.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE271
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Health Technology Assessment
Topic Subcategory
Budget Impact Analysis
Disease
Reproductive & Sexual Health, Surgery