Evaluating Health Economic Outcomes of Autologous Skin Cell Suspension (ASCS) For Definitive Closure in US Burn Care Using Contemporary Real-World Burn Center Data

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.