Cost Analysis of Abdominal Aortic Aneurysm Repair: The Economic Impact of Rising Surgical Material Costs on Public Health Insurance

TL;DR

This study compares the costs of two abdominal aortic aneurysm repair methods and finds that higher surgical material costs in one method offset other cost savings.

Contribution

The study quantifies how rising surgical material costs impact overall medical expenses in endovascular aneurysm repair compared to open repair.

Findings

EVAR had significantly higher total inpatient medical costs due to expensive surgical materials.

EVAR reduced ICU and hospital stays, blood loss, and transfusion costs compared to OAR.

Surgical material costs accounted for 58% of total expenses in EVAR cases.

Abstract

We conducted a detailed comparison of inpatient medical costs between endovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) for abdominal aortic aneurysms.

We evaluated 312 EVAR and 205 OAR cases performed at our institution between January 2007 and December 2017. Patient background characteristics were adjusted between the EVAR and OAR groups using propensity score matching (PSM). Surgical outcomes and inpatient medical costs were compared.

After PSM, 161 cases were included in each group for comparison. Operative time, blood loss, intensive care unit (ICU) stay, and hospital stay were significantly lower in the EVAR group than in the OAR group. Total inpatient medical costs were significantly higher in the EVAR group (3111× 103 vs. 2156 × 103 JPY [Japanese yen], p <0.01). The surgical material costs in the EVAR group were significantly higher than those in the OAR group, accounting for 58% of total medical expenses. Other costs (diagnosis procedure combination, ICU management, surgical procedure, transfusion, intraoperative injection, and room) were all lower in the EVAR group than in the OAR group.

The cost-saving effects of EVAR, such as reduced transfusion costs and ICU stay fees, were offset by the significantly higher cost of surgical materials.