Guidance

4 NHS considerations

4 NHS considerations

System impact

4.1

The sponsor stated that using the E‑vita open plus could allow repair of the thoracic aorta in a single procedure, when a 2-stage procedure would otherwise be necessary. It claimed that this would consequently reduce overall length of stay in hospital and reduce the risk of complications needing hospital treatment. The clinical evidence consisted of the study by Jakob et al. (2011), which contained no comparative data about resource use during other aortic repair techniques. The review and meta-analysis carried out by the sponsor focused on clinical outcomes rather than resource implications.

Committee considerations

4.2

The committee was satisfied that a second repair procedure could be avoided by using the E‑vita open plus in a selected group of people and that this could reduce associated NHS resource use.

4.3

The committee was advised that aortic repair using the E‑vita open plus is a highly specialised procedure, carried out in a small number of centres, in a small patient group. Despite these limitations, the committee considered that the potential benefits of releasing operating theatre and clinical time by avoiding the need for a second procedure could be significant. It recognised that the resources needed for treating complications associated with a second procedure (some of which would be severe and would result in long-term disability) would also be released.