IQVIA, 3110 Fairview Park Drive, Falls Church, VA, USA.
Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
Adv Ther. 2019 Jul;36(7):1715-1729. doi: 10.1007/s12325-019-00961-2. Epub 2019 May 7.
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.
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.
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.
Use of ASCS compared to SOC reduces hospital costs and LOS of severe burns in the USA.
AVITA Medical.
当将新的干预措施引入烧伤治疗时，考虑临床和经济影响非常重要，因为美国的烧伤经济负担非常沉重。本研究采用健康经济建模方法，评估使用 RECELL 自体细胞采集器制备自体皮肤细胞悬浮液 (ASCS) 与标准护理 (SOC) 相比，用于治疗需要手术干预以进行确定性闭合的严重烧伤的成本效益和烧伤中心预算影响。
采用序贯决策树的医院视角模型描述急性烧伤护理途径（伤口评估、清创/切除、临时覆盖、确定性闭合），并预测使用 ASCS 与 SOC 之间的相对差异。临床输入和 ASCS 对住院时间 (LOS) 的影响来自临床试验和实际使用数据、美国烧伤协会国家烧伤资料库分析以及烧伤外科医生访谈。医院资源使用和单位成本来自三个美国烧伤中心。预算影响计算利用蒙特卡罗模拟来估计对烧伤中心的总体影响。
ASCS 治疗在预期的患者特征和情况下，与 SOC 相比具有成本节约或成本中性（差异小于 2%），并导致 LOS 降低。总体而言，ASCS 治疗每年可为烧伤中心节省 14-17.3%的费用。结果对 ASCS 使用对 LOS、手术时间和手术次数的相对影响的假设变化敏感，但仍保持稳健。
与 SOC 相比，使用 ASCS 可降低美国严重烧伤的住院费用和 LOS。
AVITA Medical。
