A health economic cost analysis of acute endocarditis patients treated with CytoSorb during
open heart surgery suggests significant saving opportunities.
The analysis is based on a 2017 published study of Prof. Dr. med. Karl Träger.
Munich, February 21, 2019 – CytoSorbents, a critical care immunotherapy leader commercializing its CytoSorb® blood purification technology to treat deadly inflammation in critically-ill and cardiac surgery patients around the world, announced the outcomes of a recent analysis at the 48th Annual Meeting of the German Society of Thorax, Heart and Vascular Surgery, 16-19 February, 2019, in Wiesbaden, Germany. This first health economic analysis concerning the study1, entitled „Hemoadsorption treatment of patients with acute infective endocarditis during surgery with cardiopulmonary bypass – a case series,“ was conducted together with Prof. Dr. med. Karl Träger, Department of Cardiac Anesthesiology, University Hospital Ulm, Ulm, Germany.
The objectives of the analysis were to estimate the mean costs per patient of introducing CytoSorb as an adjuvant therapy compared to standard treatment without CytoSorb in the treatment of acute infective endocarditis from a German hospital perspective using intensive care unit (ICU) length of stay (LoS).
CytoSorb was used intraoperatively in patients with acute infective endocarditis (n=39). The control group was a historic cohort from the same hospital (n=28). Treated patients were overall sicker (median EuroScore II: 12.8 vs 10.2, p=0.03). Despite the low number of patients, the difference in the median ICU LoS of 2.5 days (7.5 vs. 5 days, p=0.059) suggests a reduction in the LoS.
A bootstrap analysis with 1,000 samples with 100 observations each (50:50) was performed based on the individual ICU LoS data of these patients from the university hospital. A probabilistic multivariable analysis performed by Monte Carlo simulations and a one-way sensitivity analysis to test for several cost driving variables were used to analyze the robustness of the result. Treatment with CytoSorb resulted in a median reduction in ICU LOS of 2.33 days (IQR: 1.5-3) of all treated patients according to the bootstrap analysis, a conservative estimate compared to the 2.5 days observed in the study.
The model estimated average savings of 1,660EUR per patient for the hospital with an 82% probability of being cost-saving even without any additional device-specific reimbursement. These savings rise to an average amount of 3,211EUR with a probability of 99% of being cost-saving when there is full reimbursement of the CytoSorb device costs (Fig. 1).
The costs of the ICU stay have the highest impact on the level of cost savings. However, CytoSorb remains cost saving irrespective of variations in all cost driving variables. The reduction in ICU LoS also opens the door to additional revenue for the hospital by being able to operate more patients since engaged ICU beds are often a bottleneck of a highly efficient cardiac surgery program.
Dr. Christian Steiner, Managing Director CytoSorbents Europe, said, „We strongly believe that the introduction of CytoSorb therapy has the potential to help many patients with different diseases. We are working very hard to build the necessary clinical data and evidence that it can be introduced in therapy guidelines soon.“
Prof. Dr.med. Karl Träger said, „We are using the CytoSorb therapy for several years now in different indications. The intraoperative application of CytoSorb for the treatment of acute infective endocarditis suggests a cost-saving impact, which is a great addition to the positive clinical effects we see.“
1Träger et al. IJAO. 2017; 40(5): 240-249
CytoSorb is a registered trademark of CytoSorbents Corporation.
Keywords:Blutreinigung