Economic Evaluation of Antibacterial Coatings on Healthcare Costs in First Year Following Total Joint Arthroplasty

Maria Teresa Trentinaglia, Catherine Van Der Straeten, Ilaria Morelli, Nicola Logoluso, Lorenzo Drago, Carlo L Romanò

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Antibacterial coatings (ABCs) of implants have proven safe and effective to reduce postsurgical infection, but little is known about their possible economic impact on large-scale use. This study evaluated the point of economic balance, during the first year after surgery, and the potential overall annual healthcare cost savings of 3 different antibacterial technologies applied to joint arthroplasty: a dual-antibiotic-loaded bone cement (COPAL G + C), an antibacterial hydrogel coating (DAC), and a silver coating (Agluna).

METHODS: The variables included in the algorithm were average cost and number of primary joint arthroplasties; average cost per patient of the ABC; incidence of periprosthetic joint infections and expected reduction using the ABCs; average cost of infection treatment and expected number of cases.

RESULTS: The point of economic balance for COPAL G + C, DAC, and Agluna in the first year after surgery was reached in patient populations with an expected postsurgical infection rate of 1.5%, 2.6%, and 19.2%, respectively. If applied on a national scale, in a moderately high-risk population of patients with a 5% expected postsurgical infection rate, COPAL G + C and DAC hydrogel would provide annual direct cost savings of approximately €48,800,000 and €43,200,000 (€1220 and €1080 per patient), respectively, while the silver coating would be associated with an economic loss of approximately €136,000,000.

CONCLUSION: This economic evaluation shows that ABC technologies have the potential to decrease healthcare costs primarily by decreasing the incidence of surgical site infections, provided that the technology is used in the appropriate risk class of patients.

Original languageEnglish
Pages (from-to)1656-1662
Number of pages7
JournalJournal of Arthroplasty
Volume33
Issue number6
DOIs
Publication statusPublished - Jun 2018

Fingerprint

Arthroplasty
Health Care Costs
Cost-Benefit Analysis
Joints
Economics
Infection
Cost Savings
Hydrogel
Technology
Silver
Surgical Wound Infection
Costs and Cost Analysis
Bone Cements
Incidence
Population
Anti-Bacterial Agents

Cite this

Economic Evaluation of Antibacterial Coatings on Healthcare Costs in First Year Following Total Joint Arthroplasty. / Trentinaglia, Maria Teresa; Van Der Straeten, Catherine; Morelli, Ilaria; Logoluso, Nicola; Drago, Lorenzo; Romanò, Carlo L.

In: Journal of Arthroplasty, Vol. 33, No. 6, 06.2018, p. 1656-1662.

Research output: Contribution to journalArticle

@article{060dbb09b44244c1acd1b8ef0923c1bd,
title = "Economic Evaluation of Antibacterial Coatings on Healthcare Costs in First Year Following Total Joint Arthroplasty",
abstract = "BACKGROUND: Antibacterial coatings (ABCs) of implants have proven safe and effective to reduce postsurgical infection, but little is known about their possible economic impact on large-scale use. This study evaluated the point of economic balance, during the first year after surgery, and the potential overall annual healthcare cost savings of 3 different antibacterial technologies applied to joint arthroplasty: a dual-antibiotic-loaded bone cement (COPAL G + C), an antibacterial hydrogel coating (DAC), and a silver coating (Agluna).METHODS: The variables included in the algorithm were average cost and number of primary joint arthroplasties; average cost per patient of the ABC; incidence of periprosthetic joint infections and expected reduction using the ABCs; average cost of infection treatment and expected number of cases.RESULTS: The point of economic balance for COPAL G + C, DAC, and Agluna in the first year after surgery was reached in patient populations with an expected postsurgical infection rate of 1.5{\%}, 2.6{\%}, and 19.2{\%}, respectively. If applied on a national scale, in a moderately high-risk population of patients with a 5{\%} expected postsurgical infection rate, COPAL G + C and DAC hydrogel would provide annual direct cost savings of approximately €48,800,000 and €43,200,000 (€1220 and €1080 per patient), respectively, while the silver coating would be associated with an economic loss of approximately €136,000,000.CONCLUSION: This economic evaluation shows that ABC technologies have the potential to decrease healthcare costs primarily by decreasing the incidence of surgical site infections, provided that the technology is used in the appropriate risk class of patients.",
author = "Trentinaglia, {Maria Teresa} and {Van Der Straeten}, Catherine and Ilaria Morelli and Nicola Logoluso and Lorenzo Drago and Roman{\`o}, {Carlo L}",
note = "Copyright {\circledC} 2018 Elsevier Inc. All rights reserved.",
year = "2018",
month = "6",
doi = "10.1016/j.arth.2018.01.057",
language = "English",
volume = "33",
pages = "1656--1662",
journal = "Journal of Arthroplasty",
issn = "0883-5403",
publisher = "Churchill Livingstone",
number = "6",

}

TY - JOUR

T1 - Economic Evaluation of Antibacterial Coatings on Healthcare Costs in First Year Following Total Joint Arthroplasty

AU - Trentinaglia, Maria Teresa

AU - Van Der Straeten, Catherine

AU - Morelli, Ilaria

AU - Logoluso, Nicola

AU - Drago, Lorenzo

AU - Romanò, Carlo L

N1 - Copyright © 2018 Elsevier Inc. All rights reserved.

PY - 2018/6

Y1 - 2018/6

N2 - BACKGROUND: Antibacterial coatings (ABCs) of implants have proven safe and effective to reduce postsurgical infection, but little is known about their possible economic impact on large-scale use. This study evaluated the point of economic balance, during the first year after surgery, and the potential overall annual healthcare cost savings of 3 different antibacterial technologies applied to joint arthroplasty: a dual-antibiotic-loaded bone cement (COPAL G + C), an antibacterial hydrogel coating (DAC), and a silver coating (Agluna).METHODS: The variables included in the algorithm were average cost and number of primary joint arthroplasties; average cost per patient of the ABC; incidence of periprosthetic joint infections and expected reduction using the ABCs; average cost of infection treatment and expected number of cases.RESULTS: The point of economic balance for COPAL G + C, DAC, and Agluna in the first year after surgery was reached in patient populations with an expected postsurgical infection rate of 1.5%, 2.6%, and 19.2%, respectively. If applied on a national scale, in a moderately high-risk population of patients with a 5% expected postsurgical infection rate, COPAL G + C and DAC hydrogel would provide annual direct cost savings of approximately €48,800,000 and €43,200,000 (€1220 and €1080 per patient), respectively, while the silver coating would be associated with an economic loss of approximately €136,000,000.CONCLUSION: This economic evaluation shows that ABC technologies have the potential to decrease healthcare costs primarily by decreasing the incidence of surgical site infections, provided that the technology is used in the appropriate risk class of patients.

AB - BACKGROUND: Antibacterial coatings (ABCs) of implants have proven safe and effective to reduce postsurgical infection, but little is known about their possible economic impact on large-scale use. This study evaluated the point of economic balance, during the first year after surgery, and the potential overall annual healthcare cost savings of 3 different antibacterial technologies applied to joint arthroplasty: a dual-antibiotic-loaded bone cement (COPAL G + C), an antibacterial hydrogel coating (DAC), and a silver coating (Agluna).METHODS: The variables included in the algorithm were average cost and number of primary joint arthroplasties; average cost per patient of the ABC; incidence of periprosthetic joint infections and expected reduction using the ABCs; average cost of infection treatment and expected number of cases.RESULTS: The point of economic balance for COPAL G + C, DAC, and Agluna in the first year after surgery was reached in patient populations with an expected postsurgical infection rate of 1.5%, 2.6%, and 19.2%, respectively. If applied on a national scale, in a moderately high-risk population of patients with a 5% expected postsurgical infection rate, COPAL G + C and DAC hydrogel would provide annual direct cost savings of approximately €48,800,000 and €43,200,000 (€1220 and €1080 per patient), respectively, while the silver coating would be associated with an economic loss of approximately €136,000,000.CONCLUSION: This economic evaluation shows that ABC technologies have the potential to decrease healthcare costs primarily by decreasing the incidence of surgical site infections, provided that the technology is used in the appropriate risk class of patients.

U2 - 10.1016/j.arth.2018.01.057

DO - 10.1016/j.arth.2018.01.057

M3 - Article

C2 - 29530518

VL - 33

SP - 1656

EP - 1662

JO - Journal of Arthroplasty

JF - Journal of Arthroplasty

SN - 0883-5403

IS - 6

ER -