Piemontese Alessandra, Cohen Lucas, Wright George W J, Robledinos-Antón Natalia, Jamous Nadine, Tommaselli Giovanni A, Galvain Thibaut
EMEA Health Economics & Market Access, Johnson & Johnson Medical Devices Companies, Diegem, Belgium.
EVERSANA, Burlington, Ontario, Canada.
J Med Econ. 2023 Jan-Dec;26(1):179-188. doi: 10.1080/13696998.2023.2169496.
Advanced energy devices are commonly used in electrosurgery, including ultrasonic and advanced bipolar (ABP) devices. Smoke evacuation and reusable dispersive electrodes are also utilized during electrosurgery to improve staff and patient safety. This study assessed the budget impact of adopting a portfolio of Ethicon energy devices compared to devices from other manufacturers from a Spanish hospital perspective.
The main analysis compared the Ethicon advanced energy device portfolio (ultrasonic and ABP devices) to Non-Ethicon advanced energy devices. It was assumed that 4,000 procedures using one advanced energy device each were performed annually, and the cost impact of operating room time, length of stay, and transfusions were considered. A probabilistic budget impact analysis with 10,000 iterations was conducted for generalizability to other hospitals in Spain and Europe. Secondary analysis assessed whether cost savings from the Ethicon advanced energy device portfolio could offset costs of adopting smoke evacuation and reusable dispersive electrodes (Full Ethicon energy portfolio).
In the main analysis, the annual budget impact of introducing the Ethicon advanced energy device portfolio was cost saving in 79.8% of probabilistic iterations (mean: -€945,214; 95% credible interval [CrI]: -€3,242,710; €1,285,942) with a mean budget impact per procedure of -€236 (95% CrI: -€811; €321). In the secondary analysis, adding smoke evacuation and reusable dispersive electrodes was still cost saving in 75.3% of iterations compared to Non-Ethicon advanced energy devices (mean: -€778,208; 95% CrI: -€3,075,086; €1,464,728) with a mean budget impact per procedure of -€97 (95% CrI: -€384; €183). Savings resulted from differences in operating room time, length of hospital stay, and volume of disposable electrodes.
Adopting Ethicon advanced energy devices demonstrated economic benefits compared to non-Ethicon devices. Introducing the advanced portfolio may improve surgical care quality and the full portfolio was cost saving while improving OR safety for staff and patients.
先进能量设备常用于电外科手术，包括超声设备和先进双极（ABP）设备。电外科手术期间还会使用烟雾抽吸装置和可重复使用的分散电极，以提高工作人员和患者的安全性。本研究从一家西班牙医院的角度评估了采用爱惜康能量设备组合相对于其他制造商设备的预算影响。
主要分析将爱惜康先进能量设备组合（超声设备和ABP设备）与非爱惜康先进能量设备进行了比较。假设每年使用一种先进能量设备进行4000例手术，并考虑了手术室时间、住院时间和输血的成本影响。进行了10000次迭代的概率预算影响分析，以推广到西班牙和欧洲的其他医院。次要分析评估了爱惜康先进能量设备组合节省的成本是否能够抵消采用烟雾抽吸装置和可重复使用的分散电极的成本（爱惜康完整能量设备组合）。
在主要分析中，引入爱惜康先进能量设备组合的年度预算影响在79.8%的概率迭代中实现了成本节约（均值：-945,214欧元；95%可信区间[CrI]：-3,242,710欧元；1,285,942欧元），每例手术的平均预算影响为-236欧元（95%CrI：-811欧元；321欧元）。在次要分析中，与非爱惜康先进能量设备相比，增加烟雾抽吸装置和可重复使用的分散电极在75.3%的迭代中仍实现了成本节约（均值：-778,208欧元；95%CrI：-3,075,086欧元；1,464,728欧元），每例手术的平均预算影响为-97欧元（95%CrI：-384欧元；183欧元）。节约源于手术室时间、住院时间和一次性电极用量的差异。
与非爱惜康设备相比，采用爱惜康先进能量设备显示出经济效益。引入先进设备组合可能会提高手术护理质量，完整设备组合在提高手术室工作人员和患者安全性的同时实现了成本节约。
