OBJECTIVES : To develop a Cost-Consequence analysis based on the estimated cost savings when Coseal surgical sealant (CSS) is used to seal anastomotic closures during aortic reconstruction and repair procedures.

METHODS : A Cost-Consequence Model was developed to compare resources utilization in patients who receive sutures (Standard of Care = SoC) vs. SoC plus CSS in aortic surgeries. Clinical data, such as ICU stay, length of hospitalization, Rethoracotomy, use of red blood cells (RBC) and fresh frozen plasma (FFP) has been obtained from Natour 2012. Costs have been obtained from Brazilian literature; local official sources and economic data from previous years (2016-17) has been adjusted for annual inflation. Model results include savings per patient and total budget impact if CSS would be regularly used in patients undergoing aortic surgeries.

RESULTS : CSS+SoC shows dominant versus SoC and sensitivity analysis demonstrates overall savings based on adjusted clinical parameters. Considering overall costs, treatment with CSS+SoC represents savings around -USD $7,106.23 per patient due to less days of ICU (6.4 vs. 4.3 days), hospital length of stay (21.0 vs. 16.1 days), lower incidence of Rethoracotomy (11.1% vs. 2.1%), less use of RBC (5 vs. 3.6 un) and less use of FFP (3 vs. 2.1 un). Total budget impact is -USD $710,623.44 per 100 surgeries that use CSS+SoC in the lieu of SoC. Acquisition costs (USD$ 661.40) per surgery have been compensated by savings per patient in complication and the utilization of health resources.

CONCLUSIONS : Surgical complications and use of health resources are main drivers to increased costs. This analysis demonstrates that CSS+SoC is a potentially cost-saving decision (-USD $7,106.23 per patient) that impacts the institutional budget in a positive way. Savings could be explained by lower incidence of complications, especially avoided surgical re-intervention for bleeding repairing, use of blood products and hospital length of stay.