title: 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.
  
  
  CONCLUSIONS
  In soft tissue and hepatic problematic surgical bleeding, the fibrin sealant patch may result in important hospital cost savings.
authors.affiliation: Ethicon BioSurgery, Somerville, NJ, USA.
authors.forename: Mitra
authors.initials: M
authors.lastname: Corral
authors.affiliation: Cornerstone Research Group, Burlington, ON, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Ferko
authors.affiliation: Cornerstone Research Group, Burlington, ON, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hogan
authors.affiliation: Cornerstone Research Group, Burlington, ON, Canada.
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Hollmann
authors.affiliation: Ethicon BioSurgery, Somerville, NJ, USA.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Gangoli
authors.affiliation: Ethicon Biosurgery, Wokingham, Berkshire, UK.
authors.forename: Nadine
authors.initials: N
authors.lastname: Jamous
authors.affiliation: Ethicon BioSurgery, Somerville, NJ, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Batiller
authors.affiliation: Ethicon BioSurgery, Somerville, NJ, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Kocharian
keywords: coagulopathic; cost; fibrin sealant patch; health economics; hepatic bleeding; hospital; soft tissue bleeding; surgical bleeding