Objective: The aim of this study was to model the budget impact on a hospital that incorporated use of an adhesion barrier in cesarean section (CS) surgery. Design: The study used an economic model assuming 1000 CS births in the model year, incorporating Gynecare Interceed® as the standard of care. Materials and Methods: The base case model included the following assumptions (derived from literature and publically available information): presence of adhesions=50%; $50/minute of operating room time; average increase in length of stay of 1.4 days for a CS with complications; mean cost/stay of $7,600 for CS with complications, compared to $5,700 for a CS without complications; cost of Gynecare Interceed® (Ethicon, West Somerville, NJ)=$250. A two-way sensitivity analysis was performed to test the base case model. Results: Assuming 1000 CS births took place in the model year, with 500 complicated by adhesions, the total cost of adhesions to the facility was $1,807,500/year. The cost of Gynecare Interceed/year was $250,000. Therefore, the cost savings of using Gynecare Interceed was $837,500/year. The results of the sensitivity analysis upheld the original model results. Even using conservative estimates, hospitals would still realize a cost savings of $37,999/year using Gynecare Interceed. Conclusions: This model demonstrates the cost savings to a hospital of incorporating the use of Gynecare Interceed as a standard of care in CS. Even applying conservative view, the results of the model clearly demonstrated the role of Gynecare Interceed as a cost-saving mechanism. (J GYNECOL SURG 28:207)
LiakakosT, ThomakosN, FinePM, DervenisC, YoungRL. Peritoneal adhesions: Etiology, pathophysiology, and clinical significance. Recent advances in prevention and management. Dig Surg, 2001; 18:260.
3.
PadulkaJ, StrangesE, SteinerC. Hospitalizations Related to Childbirth: HCUP Statistical Brief #110, April 2011. Agency for Healthcare Research and Quality. Rockville, MDwww.hcup-us.ahrq.gov/reports/statbriefs/sb110.pdf. 2011 May 8.
4.
MoralesKJ, GordonMC, BatesGWJr. Postcesarean delivery adhesions associated with delayed delivery of infant. Am J Obstet Gynecol, 2007; 196:461.e1.
5.
TulandiT, AgdiM, ZareiA, MinerL, SikiricaV. Adhesion development and morbidity after repeat cesarean delivery. Am J Obstet Gynecol, 2009; 201:56.e1.
6.
TulandiT, Al-SannanB, AkbarG, MinerL, ZieglerC, SikiricaV. Clinical relevance of intra-abdominal adhesions in cesarean delivery. Gynecol Surg, 2011February12e-pub ahead of print.
7.
SikirikaV, BapatB, CandrilliSD, DavisKL, JohnsA. Inpatient care and costs associated with abdominal adhesiolysis in the United States in 2005 [presentation]VIIIth Meeting of the PAX SocietyClermont-Ferrand, FranceSeptember18–20, 2008.
8.
ImaiA, SuzukiN. Topical non-barrier agents for postoperative adhesion prevention in animal models. Eur J Obstet Gynecol Reprod Biol, 2010; 149:131.
9.
ChapaHO, VenegasG, VanDuyneCP, AntonettiAG, SandateJP, SilverL. Peritoneal adhesion prevention at cesarean section: An analysis of the effectiveness of an absorbable adhesion barrier. J Reprod Med, 2011; 56,3–4:103.
WisemanDM, TroutJR, FranklinRR, DiamondMP. Metaanalysis of the safety and efficacy of an adhesion barrier (Interceed TC7) in laparotomy. J Reprod Med, 1999; 44:325.
16.
FranklinRR. Reduction of ovarian adhesions by the use of Interceed: Ovarian Adhesion Study Group. Obstet Gynecol, 1995; 86:335.
17.
KecksteinJ, UlrichU, SasseV, RothA, TuttliesF, KarageorgievaE. Reduction of postoperative adhesion formation after laparoscopic ovarian cystectomy. Hum Reprod, 1996; 11:579.
18.
SawadaT, NishizawaH, NishioE, KadowskiM. Postoperative adhesion prevention with an oxidized regenerated cellulose adhesion barrier in infertile women. J Reprod Med, 2000; 45:387.
19.
BroderMS. Adesiolysis in repeat cesarian delivery common [presentation]American Congress of Obstetricians and Gynecologists 59th Annual Clinical Meeting. Washington, DC, May3, 2011.
