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Published in: Advances in Therapy 7/2019

Open Access 01-07-2019 | Wound Debridement | Original Research

Cost-Effectiveness of the Use of Autologous Cell Harvesting Device Compared to Standard of Care for Treatment of Severe Burns in the United States

Authors: Stacey Kowal, Eliza Kruger, Pinar Bilir, James H. Holmes, IV, William Hickerson, Kevin Foster, Scott Nystrom, Jeremiah Sparks, Narayan Iyer, Katie Bush, Andrew Quick

Published in: Advances in Therapy | Issue 7/2019

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Abstract

Introduction

When introducing a new intervention into burn care, it is important to consider both clinical and economic impacts, as the financial burden of burns in the USA is significant. This study utilizes a health economic modeling approach to estimate cost-effectiveness and burn center budget-impact for the use of the RECELL® Autologous Cell Harvesting Device to prepare autologous skin cell suspension (ASCS) compared to standard of care (SOC) split-thickness skin graft (STSG) for the treatment of severe burn injuries requiring surgical intervention for definitive closure.

Methods

A hospital-perspective model using sequential decision trees depicts the acute burn care pathway (wound assessment, debridement/excision, temporary coverage, definitive closure) and predicts the relative differences between use of ASCS compared to SOC. Clinical inputs and ASCS impact on length of stay (LOS) were derived from clinical trials and real-world use data, American Burn Association National Burn Repository database analyses, and burn surgeon interviews. Hospital resource use and unit costs were derived from three US burn centers. A budget impact calculation leverages Monte Carlo simulation to estimate the overall impact to a burn center.

Results

ASCS treatment is cost-saving or cost-neutral (< 2% difference) and results in lower LOS compared to SOC across expected patient profiles and scenarios. In aggregate, ASCS treatment saves a burn center 14–17.3% annually. Results are sensitive to, but remain robust across, changing assumptions for relative impact of ASCS use on LOS, procedure time, and number of procedures.

Conclusions

Use of ASCS compared to SOC reduces hospital costs and LOS of severe burns in the USA.

Funding

AVITA Medical.
Appendix
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Literature
1.
go back to reference Pruitt B, Mason A. Epidemiological, demographic, and outcome characteristics of burn injury. In: Herndon D, editor. Total burn care. London: Saunders; 1996. p. 13. Pruitt B, Mason A. Epidemiological, demographic, and outcome characteristics of burn injury. In: Herndon D, editor. Total burn care. London: Saunders; 1996. p. 13.
6.
go back to reference Hranjec T, Turrentine FE, Stukenborg G, et al. Burn-center quality improvement: are burn outcomes dependent on admitting facilities and is there a volume-outcome “sweet-spot”? Am Surg. 2012;78:559–66.PubMedPubMedCentral Hranjec T, Turrentine FE, Stukenborg G, et al. Burn-center quality improvement: are burn outcomes dependent on admitting facilities and is there a volume-outcome “sweet-spot”? Am Surg. 2012;78:559–66.PubMedPubMedCentral
7.
go back to reference Lim J, Liew S, Chan H, et al. Is the length of time in acute burn surgery associated with poorer outcomes? Burns. 2014;40:235–40.CrossRefPubMed Lim J, Liew S, Chan H, et al. Is the length of time in acute burn surgery associated with poorer outcomes? Burns. 2014;40:235–40.CrossRefPubMed
8.
go back to reference Holmes J, Molnar J, Carter J, et al. A comparative study of the ReCell® device and autologous spit-thickness meshed skin graft in the treatment of acute burn injuries. J Burn Care Res. 2018;39:694–702.CrossRef Holmes J, Molnar J, Carter J, et al. A comparative study of the ReCell® device and autologous spit-thickness meshed skin graft in the treatment of acute burn injuries. J Burn Care Res. 2018;39:694–702.CrossRef
9.
go back to reference Gravante G, Di Fede M, Araco A, et al. A randomized trial comparing ReCell® system of epidermal cells delivery versus classic skin grafts for the treatment of deep partial thickness burns. Burns. 2007;33:966–72.CrossRefPubMed Gravante G, Di Fede M, Araco A, et al. A randomized trial comparing ReCell® system of epidermal cells delivery versus classic skin grafts for the treatment of deep partial thickness burns. Burns. 2007;33:966–72.CrossRefPubMed
11.
go back to reference Park JH, Heggie KM, Edgar DW, et al. Does the type of skin replacement surgery influence the rate of infection in acute burn injured patients? Burns. 2013;39:1386–90.CrossRefPubMed Park JH, Heggie KM, Edgar DW, et al. Does the type of skin replacement surgery influence the rate of infection in acute burn injured patients? Burns. 2013;39:1386–90.CrossRefPubMed
12.
go back to reference Israel JS, Greenhalgh DG, Gibson AL. Variations in burn excision and grafting: a survey of the American Burn Association. J Burn Care Res. 2017;38:e125–32.CrossRefPubMed Israel JS, Greenhalgh DG, Gibson AL. Variations in burn excision and grafting: a survey of the American Burn Association. J Burn Care Res. 2017;38:e125–32.CrossRefPubMed
14.
go back to reference Bilir P, Kruger E, Kowal S, et al. Abstract: Inpatient cost of acute care for severe burn patients: validation of economic model for adults and children. In: ISPOR 2018. Baltimore, 2018. Bilir P, Kruger E, Kowal S, et al. Abstract: Inpatient cost of acute care for severe burn patients: validation of economic model for adults and children. In: ISPOR 2018. Baltimore, 2018.
15.
go back to reference Kruger E, Bilir P, Kowal S, et al. Abstract: Relationship between patient characteristics and length of stay for severe burn patients: analysis of the American Burn Association National Burn Repository. In: ISPOR 2018. Baltimore, 2018. Kruger E, Bilir P, Kowal S, et al. Abstract: Relationship between patient characteristics and length of stay for severe burn patients: analysis of the American Burn Association National Burn Repository. In: ISPOR 2018. Baltimore, 2018.
16.
go back to reference American Burn Association. National Burn Repository Database Version 8.0. 2012. American Burn Association. National Burn Repository Database Version 8.0. 2012.
19.
go back to reference Holmes JH, Molnar JA, Williams JW, et al. Compassionate use of ReCell in large burns: a single-center U.S. experience. Auckland: ANZBA; 2016. Holmes JH, Molnar JA, Williams JW, et al. Compassionate use of ReCell in large burns: a single-center U.S. experience. Auckland: ANZBA; 2016.
21.
go back to reference Hoeksema H, Van de Sijpe K, Tondu T, et al. Accuracy of early burn depth assessment by laser Doppler imaging on different days post burn. Burns. 2009;35:36–45.CrossRefPubMed Hoeksema H, Van de Sijpe K, Tondu T, et al. Accuracy of early burn depth assessment by laser Doppler imaging on different days post burn. Burns. 2009;35:36–45.CrossRefPubMed
22.
go back to reference Luo G, Fan H, Sun W, et al. Blood loss during extensive escharectomy and auto-microskin grafting in adult male major burn patients. Burns. 2011;37:790–3.CrossRefPubMed Luo G, Fan H, Sun W, et al. Blood loss during extensive escharectomy and auto-microskin grafting in adult male major burn patients. Burns. 2011;37:790–3.CrossRefPubMed
Metadata
Title
Cost-Effectiveness of the Use of Autologous Cell Harvesting Device Compared to Standard of Care for Treatment of Severe Burns in the United States
Authors
Stacey Kowal
Eliza Kruger
Pinar Bilir
James H. Holmes, IV
William Hickerson
Kevin Foster
Scott Nystrom
Jeremiah Sparks
Narayan Iyer
Katie Bush
Andrew Quick
Publication date
01-07-2019
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 7/2019
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-019-00961-2

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