Procedure Costs of Peripheral Nerve Graft Reconstruction

Area of Science:

• Neurosurgery
• Regenerative Medicine
• Health Economics

Background:

• Peripheral nerve injuries can lead to lasting functional loss and pain if not treated promptly.
• Autograft has been the standard for nerve gaps over 5 mm, but allograft offers comparable recovery without additional surgical morbidity.
• Cost-effectiveness is crucial for surgical options, yet data comparing allograft and autograft nerve repair costs are limited.

Purpose of the Study:

• To compare the facility procedure costs of allograft versus autograft for peripheral nerve injury repair.
• To identify cost drivers associated with each nerve grafting method.

Main Methods:

• A retrospective, cross-sectional observational study analyzed data from the US all-payer PINC AI Healthcare Database (January 2018 - August 2020).
• Examined facility procedure costs and cost drivers for isolated single peripheral nerve injury repairs using allograft or autograft.
• Multivariable regression was used to evaluate risk-adjusted procedure cost differences in inpatient and outpatient settings.

Main Results:

• Peripheral nerve graft repairs (n=1363) were more common in outpatient settings, with over half utilizing allograft.
• No significant difference in overall procedure costs between allograft and autograft repair was observed in outpatient (P=0.43) or inpatient (P=0.71) settings.
• Autograft had higher operating room costs in outpatient settings (P<0.0001), while allograft had higher implant costs in both settings (P<0.0001).

Conclusions:

• Real-world data indicate no significant difference in procedure costs between autograft and allograft nerve repair in both inpatient and outpatient settings.
• While specific cost components like operating room and implant costs vary, the overall procedure cost remains comparable.
• Further investigation into the long-term economic implications of both nerve repair methods is warranted.