A hospital cost analysis of a fibrin sealant patch in soft tissue and hepatic surgical bleeding

Abstract

Background

Despite hemostat use, uncontrolled surgical bleeding is prevalent. Drawbacks of current hemostats include limitations with efficacy on first attempt and suboptimal ease-of-use. Evarrest^® is a novel fibrin sealant patch that has demonstrated high hemostatic efficacy compared with standard of care across bleeding severities. The objective of this study was to conduct a hospital cost analysis of the fibrin sealant patch versus standard of care in soft tissue and hepatic surgical bleeding.

Methods

The analysis quantified the 30-day costs of each comparator from a hospital perspective. Published US unit costs were applied to resource use (ie, initial treatment, retreatment, operating time, hospitalization, transfusion, and ventilator) reported in four trials. A “surgical” analysis included resources clinically related to the hemostatic benefit of the fibrin sealant patch, whereas a “hospital” analysis included all resources reported in the trials. An exploratory subgroup analysis focused solely on coagulopathic patients defined by abnormal blood test results.

Results

The surgical analysis predicted cost savings of $54 per patient with the fibrin sealant patch compared with standard of care (net cost impact: −$54 per patient; sensitivity range: −$1,320 to $1,213). The hospital analysis predicted further cost savings with the fibrin sealant patch (net cost impact of −$2,846 per patient; sensitivity range: −$1,483 to −$5,575). Subgroup analyses suggest that the fibrin sealant patch may provide dramatic cost savings in the coagulopathic subgroup of $3,233 (surgical) and $9,287 (hospital) per patient. Results were most sensitive to operating time and product units.

Conclusion

In soft tissue and hepatic problematic surgical bleeding, the fibrin sealant patch may result in important hospital cost savings.

Keywords:

• cost
• soft tissue bleeding
• hepatic bleeding
• surgical bleeding
• coagulopathic
• fibrin sealant patch
• hospital
• health economics

Supplementary materials

Table S1 Initial product utilization** and cost according to analysis population for SoC arm of all four trials

Table S2 Retreatment utilization** and cost according to analysis population for all four trials.

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Acknowledgments

The authors would like to thank Bryanna Tibensky who assisted with medical writing services.

Disclosure

MC, GG, NJ, JB, and RK were employees of Ethicon BioSurgery at the time of manuscript development, manufacturer of the Evarrest^® fibrin sealant patch. Cornerstone Research Group (NF, AH, and SH) received funding from Ethicon BioSurgery to conduct the study and prepare the manuscript. The authors report no other conflicts of interest in this work.