PIH17 - Budget Impact Of Utilizing Various Types Of Advanced Bipolar Energy (Abe) Devices Versus Conventional Bipolar Energy (Cbe) In Total Laparoscopic Hysterectomy In Canadian Hospitals

Abstract

Electrosurgical instruments have proven to be effective at achieving hemostasis in laparoscopic hysterectomy and in Canada, their usage is increasing. ABE devices have several advantages over conventional bipolar energy (CBE) including decreased thermal damage to tissue, improved ease-of-use and greater physician control. While all ABE devices have advantages over CBE technology, each of the 3 available ABE systems impact procedure time and length of stay differently. One disadvantage of all 3 ABE systems is the premium pricing as compared to CBE. This study was conducted to determine the budget impact of switching from CBE to 3 different ABE systems for benign laparoscopic hysterectomies in Canadian hospitals. The budget impact model considers the inpatient and procedural costs incurred by a Canadian hospital performing 100 procedures annually. CBE is utilized as a baseline for efficacy and each of the 3 ABE systems are compared to CBE individually. Data on the use of health care resources was obtained from published prospective randomized/non-randomized controlled trials. Additional costing data was obtained from the Ontario Case Costing Initiative and a large Canadian hospital. The device costs were collected from market research. A multivariate sensitivity analysis using a Monte Carlo simulation was completed to ensure scientific rigour. When comparing the 3 forms of ABE to CBE, EnSeal was the only technology that significantly reduced both OR time and length of stay. This reduction in health care resources offsets Enseal’s premium price resulting in an equivalent budget impact to CBE. However, the other 2 ABE systems do not show a reduction in OR time or length of stay and as a result, cost a Canadian hospital on average $30,239.93 and $93,091.44 more than CB or EnSeal per annum for laparoscopic hysterectomies. EnSeal is as cost-effective as CBE for benign laparoscopic hysterectomies in a Canadian hospital.