Kowal S, Kruger E, Bilir P, Holmes JH, Hickerson W, Foster K, Nystrom S, Sparks J, Iyer N, Bush K, Quick A, et al.
Advances in therapy. Date of publication 2019 May 7;volume ():.
1. Adv Ther. 2019 May 7. doi: 10.1007/s12325-019-00961-2. [Epub ahead of print]
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 S(1), Kruger E(2), Bilir P(2), Holmes JH(3), Hickerson W(4), Foster K(5),
Nystrom S(6), Sparks J(7), Iyer N(8), Bush K(7), Quick A(7).
Author information:
(1)IQVIA, 3110 Fairview Park Drive, Falls Church, VA, USA.
skowal@us.imshealth.com.
(2)IQVIA, 3110 Fairview Park Drive, Falls Church, VA, USA.
(3)Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
(4)University of Tennessee Health Science Center, Memphis, TN, USA.
(5)Arizona Burn Center, Phoenix, AZ, USA.
(6)Office of Assistant Secretary for Preparedness and Response (ASPR), US
Department of Health and Human Services (HHS), Washington, USA.
(7)AVITA Medical, Valencia, CA, USA.
(8)Biomedical Advanced Research and Development Authority (BARDA), Office of
Assistant Secretary for Preparedness and Response (ASPR), US Department of Health
and Human Services (HHS), Washington, USA.
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.
DOI: 10.1007/s12325-019-00961-2
PMID: 31065995
