Highlights
- •Increase the probability that the procedure can be performed on a day-case basis.
- •Cost saving £4.5 million annually for the National Health Service in England
- •Cost savings of £176 per procedure due to fewer inpatient stays.
- •Decrease the resource use and cost burden associated with endovascular procedures.
Abstract
Objectives
To evaluate the annual costs and budget impact of using a vascular closure device
to achieve haemostasis following femoral access endovascular procedures in England,
compared with manual compression.
Methods
A budget impact model was developed in Microsoft® Excel, based on the estimated number
of peripheral endovascular procedures eligible for day-case management performed annually
by the National Health Service in England. The clinical effectiveness of vascular
closure devices was captured based on the requirement for inpatient stays and the
incidence of complications. Data for endovascular procedures, time to haemostasis,
length of hospital stay, and complications were collected from public sources and
the published literature. There were no patients involved in this study. Model outcomes
are reported as estimated number of bed days and annual costs to the National Health
Service for all peripheral endovascular procedures in England, and the average cost
per procedure. The robustness of the model was tested in a sensitivity analysis.
Results
The model estimated savings for the National Health Service of up to £4.5 million
annually if vascular closure devices were used in every procedure instead of manual
compression. The model estimated an average cost saving of £176 per procedure for
vascular closure devices over manual compression, primarily due to fewer inpatient
stays. The sensitivity analysis demonstrated that the proportion of day-case procedures
for vascular closure devices and manual compression was a key driver of costs and
savings.
Conclusions
The use of vascular closure devices for achieving haemostasis after peripheral endovascular
procedures may be associated with lower resource use and cost burden, compared with
manual compression, based on shorter time to haemostasis and ambulation and an increased
likelihood of a day-case procedure.
Key words
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Article info
Publication history
Accepted:
February 9,
2023
Received in revised form:
February 8,
2023
Received:
June 19,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
