Abstract
Background: As new treatments for managing patients with burn injuries become available, it is imperative to consider the overall potential impact of both patient outcomes and costs to the burn center (BC). Health economic evaluations (HEE) can aid BC to assess new treatment options. Historically, the National Burn Repository (NBR) has aided in HEE with two limitations- variables are captured in an aggregate fashion over a 10-year period and it has limited data on resource utilization and procedure types. This prohibits real-world evidence development and effective HEE for new treatments. Our goal was to collect timely real-world data (RWD) and conduct a HEE to better understand the differences between anecdotal evidence and RWD in burn care treatment patterns and outcomes. Objective: To re-evaluate the economic impact of Autologous Skin Cell Suspension (ASCS) by conducting a primary research survey using RWD from BC on the current state of treatment care in order to identify trends since 2011 that impact evaluation of new interventions. Methods: 10% of U.S. burn centers were surveyed in 2019 by a panel of health economists on current BC practice patterns and outcomes. Survey data functioned as RWD with NBR 8.0 data in a previously developed health economic model (BEACON). A HEE was conducted with ASCS compared to standard of care (SOC) in a cost-effectiveness model for inpatients with deep-partial thickness (DPT) and full-thickness (FT) burn injury involving >10%TBSA. The costs-effectiveness model incorporated costs of patient care from RWD and data from the NBR predictive equations method. Results: ASCS was cost-saving in both FT and DPT burns across all TBSA ranges. Cost savings increased with burn size due to the reduced number of autograft procedures, LOS and costs compared to SOC. Savings ranged from 1% to 43% in 10% and 40 % TBSA, respectively in FT, and 25% to 41% in 10% and 40% TBSA, respectively among DPT burns. For a hypothetical BC with an average of 341 patients, the use of ASCS is expected to reduce overall costs by an estimated $15.8M for the center and $79.5K (17.4% reduction) per patient, on average. Conclusion: The study provides the first HEE from RWD confirming the BEACON model and the potential of new technologies in burn care. We observed that use of ASCS has the potential to provide substantial financial savings to BC, corroborating findings of the original HEE of ASCS with the BEACON model.
Highlights
Every year, there are around 180,000 deaths worldwide due to burns, with non-fatal burn injuries being a leading cause of morbidity such as prolonged hospitalization, and disfigurement and disability[1]
The National Burn Repository (NBR) captures a range of concepts, the public summary reports most readily available to burn centers focus on aggregate data, and comparison of trends based on patient characteristics such as age, TBSA and burn depth are not possible because nuanced results are not reported across key variables such as length of stay (LOS), procedure trends and resource use
The objective of the current study is to re-evaluate the economic impact of Autologous Skin Cell Suspension (ASCS) by integrating realworld data from burn centers on the current state (2019) of burn care obtained through a primary data collection into validating the findings of the original economic evaluation of ASCS given the advances in burn care
Summary
There are around 180,000 deaths worldwide due to burns, with non-fatal burn injuries being a leading cause of morbidity such as prolonged hospitalization, and disfigurement and disability[1]. The NBR captures a range of concepts, the public summary reports most readily available to burn centers focus on aggregate data, and comparison of trends based on patient characteristics such as age, TBSA and burn depth are not possible because nuanced results are not reported across key variables such as LOS, procedure trends and resource use. Real world data has been defined by the Federal Drug Administration (FDA) as data relating to patient health status or the delivery of health care It can be collected from electronic health records, claims or billing activity, disease or injury registries, and even patient-generated data from personal devices. Third-party payers use the data to develop guidelines and decision support tools for coverage decisions which directly impacts patients and health professions These changes with the information age have increased the value of real-world data and led to the development of real-world evidence. The objective of the current study is to re-evaluate the economic impact of ASCS by integrating realworld data from burn centers on the current state (2019) of burn care obtained through a primary data collection into validating the findings of the original economic evaluation of ASCS given the advances in burn care
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