OBJECTIVES : Postoperative cerebrospinal fluid (CSF) leaks, pseudomeningoceles, and device related infections are among the most common and challenging complications in cranial and spinal neurosurgery, requiring revision surgeries and prolonged hospitalization, therefore resulting in increased healthcare costs. This analysis aims to estimate the budget impact of using Adherus Dural Sealant as an adjunct to standard methods of dural repair, such as sutures, to provide watertight closure during cranial procedures.

METHODS : A health economic model was developed comparing three different treatment scenarios for performing cranial procedures: [I] standard dural closures (no dural sealant), dural closure with dural sealants: [II] DuraSeal, or [III] Adherus Dural Sealant. Data from published clinical trial results for the number of patients (117 for standard closures, 117 for DuraSeal, and 114 for Adherus), treatment costs (€875 for dural sealant), post-operative complications (5 revisions with standard dural closures, 5 with DuraSeal, 1 with Adherus) and costs associated with treatment of complications (€48.898 for each revision) were used to estimate (i) the total costs and (ii) costs per patient associated with using each of the treatment options. Results are presented in EUR at 2021 price level.

RESULTS : Costs associated with using dural sealant were $0 for standard dural closures, €102.375 for DuraSeal, and €99.750 for Adherus. Costs associated with performing revisions were €244.491 for standard dural closures, €244.491 for DuraSeal, and €48.898 for Adherus. Total costs were estimated to be €244.491 for standard dural closures, €346.866 for DuraSeal, and €148.648 for Adherus. This resulted in costs per patient as: €2.090 for standard dural closures, €2.965 for DuraSeal, and €1.304 for Adherus.

CONCLUSIONS : Results from this model analysis suggest that, compared to standard dural closures, the use of Adherus in performing cranial procedures potentially has a positive budget impact driven by reduced post-operative complications and increased healthcare cost-savings.