Budget Impact Analysis of the Use of Specific Biomarkers GFAP and UCH-L1 in the Management of Mild Traumatic Brain Injury in Spain

Objective: To evaluate the economic impact associated with the use of specific brain biomarkers glial fibrillary acid protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) in adult patients with suspected mild traumatic brain injury (TBI) in a standard Spanish hospital setting. Methods: We used a budget impact analysis (BIA) to compare the cost of standard of care using head computed tomography (CT) to evaluate intracranial injury with a scenario incorporating specific biomarkers GFAP and UCH-L1 in an estimated population of 3500 adult patients attending the hospital emergency department with a score of 13 to 15 on the Glasgow Coma Scale (GCS). The probabilities associated with clinical procedures were obtained from a multidisciplinary group of experts from Spanish hospitals and supplemented with data from the literature. Costs were estimated using hospital tariffs from the Spanish autonomous communities and other official sources. Results: The incorporation of specific biomarkers GFAP and UCH-L1 in the management of mild TBI could generate an estimated annual savings of EUR 696,634 in a standard Spanish hospital, mainly due to reduced CT use. The average savings per patient would be EUR 199.04, and the care time would be reduced by 111 min. Sensitivity analysis, with variations of ±20% in the parameters, confirms these savings. Conclusions: This study suggests that the use of specific biomarkers GFAP and UCH-L1 in the management of mild TBI patients in Spain could reduce the average cost per patient, generating significant savings for hospitals. Future studies that incorporate data from clinical records will help validate these results.