PBI23 A COST ANALYSIS OF HEMOSTATIC SURGICAL RESOURCES ASSOCIATED WITH A NOVEL FIBRIN SEALANT COMPARED TO STANDARD OF CARE ACROSS SURGERY TYPES

Abstract

Surgical bleeding is associated with a substantial economic burden due to additional treatments and time required if initial method of hemostasis or application of a hemostatic agent is ineffective. This study assessed costs associated with the use of hemostatic resources after first application of a new fibrin sealant, Vistaseal® (Veraseal® outside the US, manufactured by Grifols), or standard of care (SoC) in various surgical populations. Using patient-level data from 3 prospective, randomized, clinical trials, the use of additional hemostatic treatments was extracted for Vistaseal® and SoC (Surgicel or manual compression) in peripheral vascular, liver, and soft tissue surgeries. Treatment failures resulted in the use of alternative hemostatic treatments or maneuvers during or after the 10-minute observation period and until incision closure. Data were extracted for both overall and higher risk bleeding populations. Costs for hemostatic treatments were taken from public literature, and when necessary, inflated to 2019 values. Across different surgery types, use of Vistaseal® was associated with a lesser use of additional hemostatic treatments (ranging from 0.9%-7.8%) compared to SoC (ranging from 8.0%-16.7%). Additional treatments used to achieve hemostasis included energy-based methods (i.e., cautery, argon beam, bipolar devices), traditional methods (i.e., manual compression, sutures, staples, clips) and hemostats (i.e., Surgicel, Floseal, Avitene, Surgifoam). The average cost of additional hemostatic treatments ranged from $65 to $225. Assuming a hypothetical cohort of 10,000 patients, use of Vistaseal® could avoid $57,500 to $159,100 in additional treatment costs compared to SoC. In high risk bleeding populations, use of Vistaseal® resulted in further reductions in additional treatments, potentially increasing the costs avoided. Use of a new fibrin sealant, Vistaseal®, may result in important resource efficiencies for hospitals compared to SoC due to its ability to achieve durable hemostasis quickly independently of patient’s coagulation status. Potential economic benefits due to avoided complications were not evaluated