Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Hemoadsorption Using CytoSorbÒ in Patients with Infective Endocarditis: A German-Based Budget Impact Analysis

Cristina Rao
* ORCID logo ,
Franziska Preissing
,
Matthias Thielmann
,
Daniel Wendt
,
Zaki Haidari
,
Jurij Matija Kalisnik
ORCID logo ,
Lothar Daake
,
Karl Traeger
Version 1 : Received: 26 July 2023 / Approved: 27 July 2023 / Online: 27 July 2023 (10:08:25 CEST)

A peer-reviewed article of this Preprint also exists.

Rao, C.; Preissing, F.; Thielmann, M.; Wendt, D.; Haidari, Z.; Kalisnik, J.M.; Daake, L.; Traeger, K. Hemoadsorption Using CytoSorb® in Patients with Infective Endocarditis: A German-Based Budget Impact Analysis. J. Cardiovasc. Dev. Dis. 2023, 10, 366. Rao, C.; Preissing, F.; Thielmann, M.; Wendt, D.; Haidari, Z.; Kalisnik, J.M.; Daake, L.; Traeger, K. Hemoadsorption Using CytoSorb® in Patients with Infective Endocarditis: A German-Based Budget Impact Analysis. J. Cardiovasc. Dev. Dis. 2023, 10, 366.

Abstract

A considerable number of infective endocarditis (IE) patients require cardiac surgery with an increased risk for postoperative sepsis. Intraoperative hemoadsorption may diminish the risk of postoperative hyperinflammation with potential economic implications for intensive care unit (ICU) occupation. The present study aimed to theoretically investigate the budget impact of a reduced length of ICU stay in IE patients treated with intraoperative hemoadsorption in the German healthcare system. Data on ICU occupation were extrapolated from a retrospective study on IE patients treated with hemoadsorption. An Excel-based budget impact model was developed to simulate the patient course over the ICU-stay. A base-case scenario without therapy reimbursement and a scenario with full therapy reimbursement were explored. The annual eligible German IE patient population was derived from official German Diagnostic Related Group (DRG) volume data. One-way deterministic sensitivity analysis and bootstrap analysis were performed to evaluate the uncertainty over the model results. Use of intraoperative hemoadsorption resulted in 2,298€ saved per patient in the base-case scenario without therapy reimbursement. Savings increased to 3,804€ per patient in case of full device-specific reimbursement. Deterministic and probabilistic sensitivity analyses confirmed the robustness of savings, with a probability of savings of 99% and 100% in the base-case and full reimbursement scenario, respectively. Intraoperative hemoadsorption in IE patients might have relevant economic benefits related to reduced ICU stay, resulting in improved resource use. Further evaluations in larger prospective cohorts are warranted.

Keywords

acute infective endocarditis; extracorporeal techniques; hemoadsorption; cytosorb: cardiopulmonary bypass surgery; economic evaluation

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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