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

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-...

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Autores principales: Kowal, Stacey, Kruger, Eliza, Bilir, Pinar, Holmes, James H., Hickerson, William, Foster, Kevin, Nystrom, Scott, Sparks, Jeremiah, Iyer, Narayan, Bush, Katie, Quick, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647544/
https://www.ncbi.nlm.nih.gov/pubmed/31065995
http://dx.doi.org/10.1007/s12325-019-00961-2
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author Kowal, Stacey
Kruger, Eliza
Bilir, Pinar
Holmes, James H.
Hickerson, William
Foster, Kevin
Nystrom, Scott
Sparks, Jeremiah
Iyer, Narayan
Bush, Katie
Quick, Andrew
author_facet Kowal, Stacey
Kruger, Eliza
Bilir, Pinar
Holmes, James H.
Hickerson, William
Foster, Kevin
Nystrom, Scott
Sparks, Jeremiah
Iyer, Narayan
Bush, Katie
Quick, Andrew
author_sort Kowal, Stacey
collection PubMed
description 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12325-019-00961-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-66475442019-08-09 Cost-Effectiveness of the Use of Autologous Cell Harvesting Device Compared to Standard of Care for Treatment of Severe Burns in the United States Kowal, Stacey Kruger, Eliza Bilir, Pinar Holmes, James H. Hickerson, William Foster, Kevin Nystrom, Scott Sparks, Jeremiah Iyer, Narayan Bush, Katie Quick, Andrew Adv Ther Original Research 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12325-019-00961-2) contains supplementary material, which is available to authorized users. Springer Healthcare 2019-05-07 2019 /pmc/articles/PMC6647544/ /pubmed/31065995 http://dx.doi.org/10.1007/s12325-019-00961-2 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Kowal, Stacey
Kruger, Eliza
Bilir, Pinar
Holmes, James H.
Hickerson, William
Foster, Kevin
Nystrom, Scott
Sparks, Jeremiah
Iyer, Narayan
Bush, Katie
Quick, Andrew
Cost-Effectiveness of the Use of Autologous Cell Harvesting Device Compared to Standard of Care for Treatment of Severe Burns in the United States
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
title_full Cost-Effectiveness of the Use of Autologous Cell Harvesting Device Compared to Standard of Care for Treatment of Severe Burns in the United States
title_fullStr Cost-Effectiveness of the Use of Autologous Cell Harvesting Device Compared to Standard of Care for Treatment of Severe Burns in the United States
title_full_unstemmed Cost-Effectiveness of the Use of Autologous Cell Harvesting Device Compared to Standard of Care for Treatment of Severe Burns in the United States
title_short Cost-Effectiveness of the Use of Autologous Cell Harvesting Device Compared to Standard of Care for Treatment of Severe Burns in the United States
title_sort cost-effectiveness of the use of autologous cell harvesting device compared to standard of care for treatment of severe burns in the united states
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647544/
https://www.ncbi.nlm.nih.gov/pubmed/31065995
http://dx.doi.org/10.1007/s12325-019-00961-2
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