THE ECONOMIC IMPACT OF FIBRIN SEALANTS USED FOR HEMOSTASIS IN CORONARY ARTERY BYPASS GRAFTING SURGERY; AN ITALIAN PERSPECTIVE
Author(s)
Parago V1, Jamous N2
1Johnson & Johnson Medical Devices, Pomezia, Italy, 2Johnson & Johnson Medical Ltd, Berkshire, UK
OBJECTIVES: Bleeding is a serious complication related to Coronary Artery Bypass Grafting (CABG) surgery with a potential high impact on clinical outcomes and health care services expenditure. The aim of this study is to evaluate the impact on economic resource consumption associated with the use of fibrin sealants in a comparative analysis between Evicel and Tisseel METHODS: Analysis was developed to estimate the impact on costs associated with use of Evicel and Tisseel from the Italian National Healthcare System perspective with a 30-day time horizon, including the following item costs: fibrin sealant use, blood transfusion, readmissions. A literature research was performed to assess efficacy data in terms of blood transfusion rate and 30-day readmission rate associated with both fibrin sealants. The economic data on blood transfusion and fibrin sealant use were estimated on basis of the corresponding national reimbursement fees, while the costs associated with readmission were estimated according to DRG tariffs. Univariate sensitivity analysis was conducted to determine whether results were insensitive to variations in uncertain parameters. RESULTS: The literature research showed a lower blood transfusion rate on the index CABG surgery date (19% versus 34%) and after index date (9% versus 15%), as well as, a lower readmission rate (16% vs. 31.9%) in favor of use of Evicel. The economic analysis showed a lower transfusion cost for Evicel than Tisseel 22.64% (€ 65.60 versus € 84.80) and a lower readmission costs of 43.75% (€ 1,148.87 versus € 2,042.43), showing a total cost savings of € 1,045.20 per patient, including fibrin sealant cost. The sensitivity analysis shows that resulting cost-saving was most sensitive to 30-day readmission associated with the fibrin sealants. CONCLUSIONS: Detailed comparative analysis of the data has specifically shown that during CABG surgery, Evicel is associated with lower bleeding events and lower health-resource utilization/cost than Tisseel.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PHP93
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Multiple Diseases