38 Cost-effectiveness of Autologous Cell Harvesting Device for the Treatment of Burns Requiring Hospitalization: An Economic Evaluation Using Real World Data

Abstract

\n \n \n Value is a prominent issue in healthcare measured by the clinical outcomes of good medical practices relative to the literal or figurative costs of care. As a result, cost effectiveness has become an essential measure when assessing new technologies in burn care. To help providers evaluate cost-effectiveness, the BEACON model was developed in 2018 using National Burn Repository (NBR) data. While the NBR data has tremendous value portraying a cumulative picture of burn care, it lacks resolution for new innovations such as autologous skin cell suspension (ASCS). In BEACON, ASCS was shown to reduce costs associated with the current treatment of severe burns, where this cost-saving was attributed to reductions in length of stay (LOS), the number of operations, the donor site size, and associated wound care. Our study examines the efficacy of the BEACON model by performing a multicenter real-world data (RWD) analysis of primary cost-savings measures of reduced LOS for patients treated with ASCS vs. standard of care (SOC).\n \n \n \n De-identified electronic medical record data was collected over a 20-month period (1/2019 to 8/2020) from 43 burn centers in 14 states. Patients with burn injuries treated with ASCS were matched by age, gender, TBSA, and comorbidities to patients treated by current SOC treatment. Injury severity was calculated as categorical data with intervals: < 10%, 10–19%, 20–29%, 30–39%, and 40–49% TBSA. Co-morbidities were also assessed to facilitate a 1:1 comparison of patients across the two cohorts. Cost analysis was determined prior peer-reviewed literature in burn care.\n \n \n \n A total of 2,438 patients were reviewed, and 162 were used in the matched cohort analysis (n=81 in each cohort). In these patients, 68% had < 20% TBSA. When comparing patients matched on co-morbidities, burn %TBSA/extent, age, and gender, ASCS patients had a shorter LOS by 4.1 days. At an assumed cost of $6,795 per day, these differences in LOS produced a savings of over $28,000 in hospital bed costs alone per ASCS patient versus SOC. LOS was the same or shorter for ASCS patients in 63% of cases with an average reduction of 4.1 days resulting in an overall savings of $2,269,530 for ASCS-treated patients compared to SOC.\n \n \n \n Our study is the largest RWD cost-effectiveness analysis of ASCS vs SOC. This analysis confirms the BEACON model with savings primarily originating from reducing LOS, even for small burns with 68% of patients having burns less than 20% TBSA.\n