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Budget Impact Analysis of Three Presurgical Antisepsis Protocols Authors: Siting Zhou, PhD candidate, Angeline Carlson, PhD, University of Minnesota

Contact:Sally Bull3M Infection Prevention3M Center 270-4N-01St. Paul, MN 55144sjbull@mmm.com651-736-3934

Budget Impact Analysis of Three Presurgical Skin Antisepsis ProtocolsAuthors: Siting Zhou, PhD candidate, Angeline Carlson, PhD, University of Minnesota

Conclusions: Based on 100 surgeries, DuraPrep solution provides bothtime and cost savings relative to povidone-iodine and ChloraPrep.

Results:• PI had the lowest product

cost, but its skin preparation protocol took 5 times longer than DuraPrep or ChloraPrep, resulting in large presurgical expenditures.

• At the one unit level, ChloraPrep was 1.7 times more expensive than DuraPrep and 4 times more expensive than PI.

• ChloraPrep also had the highest SSI rate3 (DuraPrep:3.91%, ChloraPrep: 7.14%, PI: 6.38%: P=.002).

• DuraPrep resulted in cost-savings compared to both PI and ChloraPrep.

1 3M™ DuraPrep™ Surgical Solution(Iodine Povacrylex [0.7% available iodine]and Isopropyl Alcohol, 74% w/w) PatientPreoperative Skin Preparation

2 ChloraPrep® Patient Preoperative SkinPreparation 2% Chlorhexidine Gluconate(CHG) & 70% Isopropyl Alcohol (IPA)

3 Swenson BR, Hedrick TL, Metzger R,Bonatti H, Pruett TL, Sawyer RG. Effectsof preoperative skin preparation onpostoperative wound infection rates: aprospective study of 3 skin preparationprotocols. Infect Control Hosp Epidemiol2009; 30:964-971. (PI prep included anisopropyl alcohol paint)

Financial Disclosure:The research was funded by 3M Healthcare, Infection Prevention Division, Clinical

Presented on March 21, 2010, at the Fifth Decennial International Conference on Healthcare-Associated Infections 2010, in Atlanta, Georgia, Poster #877

Objectives: Surgical site infections(SSIs) occur in up to 11.6% ofsurgeries. SSIs carry an associatedcost. Optimization of presurgical skinantisepsis mitigates the risk of SSIs.The purpose of this study was toestimate the net budget impact ofthree antisepsis techniques:DuraPrep solution1, ChloraPrepantiseptic2, and povidone-iodinescrub-paint (PI).

Methods: A budget impact analysisusing International Society ofPharmacoeconomics and OutcomesResearch (ISPOR) and Canadianguidelines was completed.• Costs associated with DuraPrep

solution, ChloraPrep, and PI were obtained from current market sources.

• Rates of SSIs were derived from published clinical studies3.Incremental costs to treat SSIs were derived from literature and adjusted to current U.S. dollars using the medical component of the Consumer Price Index.

• Presurgical skin preparation time estimates were obtained from product literature and costs calculated based on per minute surgical suite charges.

• Total cost per 100 surgeries was calculated: [antisepsis cost per one unit + costs of presurgical preparation + incremental costs to treat SSIs]

Surgery Variables ChloraPrepantiseptic

DuraPrepSolution

Povidone-Iodine

Product cost (per 100 surgeries)Unit Price*Quantity (per typical surgery)*cost obtained from current market source

$708.00$7.08

1

$427.00$4.27

1

$171.00$1.71

1

Preparation cost (per 100 surgeries)Operating room charge (per min)Preparation time* (min)*when used per instructions

$25,000.00$50.00

5

$25,000.00$50.00

5

$65,000.00$50.00

13

Product cost (per 100 surgeries)Mean cost of each SSI

Number of surgeriesInfection rate 3

$225,345.54$31,561

1000.0714

$123,403.51$31,561

1000.0391

$201,359.18$31,561

1000.0638

SSIs per 100 surgeries 7.14 3.91 6.38

Total cost $251,053.54 $148,830.51 $266,530.18

Incremental cost differences between prepsDuraPrep solution vs. ChloraPrepDuraPrep solution vs. Povidone-IodineChloraPrep vs. Povidone-Iodine

$148,831 - $251,054

$148,831 - $266,530

$251,054 - $266,530

($102,223.03)($117,699.67)($15,476.64)