Economic Impact Analysis of Custom Pak^® on Cataract and Vitreoretinal Surgery in the United States

Abstract

Purpose

Implicit costs of surgical preparation and materials management for cataract/anterior segment and retinal/posterior segment procedures are often unquantified. Use of ophthalmological surgical procedure packs is common in these surgeries; however, there is little in the literature demonstrating their time and cost impacts. Understanding the costs and potential benefits of surgical pack procedure use is important for administrators in purchasing decision-making. The objective of this study is to estimate the economic impact of Alcon Custom Pak^® on cataract and vitreoretinal (retina) surgery in hospitals and ambulatory surgical centers (ASCs) across operating room (OR), materials management, and accounting departments.

Methods

We conducted a study in 2019 among US hospitals and ASCs using an online survey and a surgery timing exercise. Surgical technicians and supply chain managers were surveyed regarding current cataract and retina surgery practices including OR, materials management, and accounting tasks. Surgical technicians timed cataract and retina surgeries, recording activity timestamps and surgical supply use from Alcon Custom Pak and other sources. Using the survey and timing exercise inputs and literature and government sources, we developed a budget impact model (BIM) to quantify hidden costs of time and labor spent across the entire surgery supply life cycle.

Results

Representing a geographical mix of 99 facilities, surgical technicians (56 cataract/46 retina) and supply chain managers (23 cataract/24 retina) provided data for their institutions. Technicians timed 290 cataract and 250 retina surgeries. In the BIM, increasing baseline Custom Pak utilization to 100% of surgeries while also sourcing all relevant supplies from Custom Pak results in annual cost savings ranging from $92,273 to $217,675 across procedure type and setting, allowing for between 75 (retina ASC) and 266 (cataract hospital) potential additional procedures per facility/year.

Conclusion

This study demonstrates that increasing Custom Pak usage can potentially save time, reduce hidden costs, and increase throughput.

Keywords:

• cataract
• retina
• vitreoretinal surgery
• surgical instruments
• model
• economic
• hospital materials management

Abbreviations

ASC, ambulatory surgical center; BIM, budget impact model; CPI; consumer price index; OR, operating room; SD; standard deviation; US, United States; USD, United States dollar.

Data Sharing Statement

The datasets generated and/or analyzed during the current study are not publicly available due to the proprietary and confidential nature of the data, but the models and methodology can be obtained from the corresponding author.

Ethics Approval and Consent to Participate

Western Institutional Review Board prospectively reviewed the study and considered it exempt because it is an online survey with adequate protections in place to protect the privacy of subjects and to maintain the confidentiality of data. The study and data accumulation were in conformity with all country, federal, or state laws, informed consent was obtained from participants, and the study was in adherence to the tenets of the Declaration of Helsinki.

Author Contributions

JSD made substantial contribution to the conception and design of the work. JSD made substantial contribution to the acquisition of data. JSD was primarily responsible for the statistical analysis of the data. JSD and RH were primarily responsible for drafting the manuscript. BDA, OPG, CH, RK, and SDS substantially revised or critically reviewed the manuscript. All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

BDA is a consultant for Alcon, Allergan, Bausch and Lomb, Carl Zeiss Meditec, and Omeros. OPG is a consultant for Alcon. SDS is a consultant for Alcon. RH is an employee of KJT Group, Inc. which was contracted by Alcon to conduct the study and provide medical writing support. At the time this study was conducted and the manuscript was written, JSD was an employee of KJT Group, Inc. CWH and RK are employees of Alcon, the sponsor of this research. The authors report no other conflicts of interest in this work.

Additional information

Funding

This study was supported by Alcon Vision LLC, which had a role in the study design, data collection, analysis, and interpretation of data; Alcon also funded the medical writing support provided by KJT Group, Inc.