Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-23T06:01:59.642Z Has data issue: false hasContentIssue false
  • English
  • Français

Economic Spillovers From Public Investments in Medical Countermeasures: A Case Study of a Burn Debridement Product

Published online by Cambridge University Press:  19 June 2017

Farah Farahati ,
Scott Nystrom ,
David R. Howell  and
Richard Jaffe
Farah Farahati*
Affiliation:
Gap Solutions, Inc, contractor to the US Department of Health and Human Services, and University of Maryland, School of Public Health, Department of Health Services Administration, College Park, Maryland
Scott Nystrom
Affiliation:
US Department of Health and Human Services, Assistant Secretary for Preparedness and Response, Washington, DC
David R. Howell
Affiliation:
US Department of Health and Human Services, Assistant Secretary for Preparedness and Response, Washington, DC
Richard Jaffe
Affiliation:
US Department of Health and Human Services, Assistant Secretary for Preparedness and Response, Washington, DC
*
Correspondence and reprint requests to Farah Farahati, University of Maryland, School of Public Health, 3310D School of Public Health (Bldg #255), 4200 Valley Drive, College Park, MD 20742-2611 (e-mail: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

The US federal government invests in the development of medical countermeasures for addressing adverse health effects to the civilian population from chemical, biological, and radiological or nuclear threats. We model the potential economic spillover effects in day-to-day burn care for a federal investment in a burn debridement product for responding to an improvised nuclear device.

Methods

We identify and assess 4 primary components for projecting the potential economic spillover benefits of a burn debridement product: (1) market size, (2) clinical effectiveness and cost-effectiveness, (3) product cost, and (4) market adoption rates. Primary data sources were the American Burn Association’s 2015 National Burn Repository Annual Report of Data and published clinical studies used to gain European approval for the burn debridement product.

Results

The study results showed that if approved for use in the United States, the burn debridement product has potential economic spillover benefits exceeding the federal government’s initial investment of $24 million a few years after introduction into the burn care market.

Conclusions

Economic spillover analyses can help to inform the prioritizing of scarce resources for research and development of medical countermeasures by the federal government. Future federal medical countermeasure research and development investments could incorporate economic spillover analysis to assess investment options. (Disaster Med Public Health Preparedness. 2017;11:711–719)

Keywords

emergency medicinehealth care economics and organizationscost-effectivenessspilloverBass diffusion model
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 11 , Issue 6 , December 2017 , pp. 711 - 719
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Drs Farahati and Nystrom contributed equally to this article.

References

REFERENCES

1. US Department of Health and Human Services. 2015 PHEMCE Strategy and Implementation Plan. Public Health Emergency website. http://www.phe.gov/Preparedness/mcm/phemce/Pages/strategy.aspx. Last updated January 3, 2017. Accessed May 12, 2017.Google Scholar
2. Department of Health and Human Services, Office of the Secretary, Office of Public Health Emergency Preparedness. Statement of organization, functions, and delegations of authority. Fed Regist. 2006;71(129):38403. http://www.gpo.gov/fdsys/pkg/FR-2006-07-06/pdf/06-6004.pdf.Google Scholar
3. US Department of Health and Human Services. Biomedical Advanced Research and Development Authority. http://www.phe.gov/about/BARDA/Pages/default.aspx. Public Health Emergency website. Accessed May 12, 2017.Google Scholar
4. Jaffe, AB. The importance of “spillovers” in the policy mission of the advanced technology program. J Technol Transf. 1998;23(2):11-19. http://link.springer.com/article/10.1007/BF02509888. https://doi.org/10.1007/BF02509888 Google Scholar
5. Angelucci, M, Di Maro, V. Program Evaluation and Spillover Effects. Policy Research Working Paper no. WPS7243. Washington, DC: World Bank Group; 2015. http://documents.worldbank.org/curated/en/137731468171858310/Program-evaluation-and-spillover-effects. https://doi.org/10.1596/1813-9450-7243.Google Scholar
6. Herber, BP. Modern Public Finance. 5th ed. Homewood, IL: Richard D. Irwin; 1983.Google Scholar
7. Jones, CI, Williams, JC. Measuring the social return to R&D. Q J Econ. 1998;113(4):1119-1135. https://doi.org/10.1162/003355398555856.Google Scholar
8. Schnorpfeil, W. Health economic considerations to a new debriding agent for deep partial and full thickness burns. Ann Burns Fire Disasters. 2015;28(suppl EBA). http://www.medbc.com/annals/review/vol_28/num_3b/text/vol28n3bp387.pdf.Google Scholar
9. US Department of Health and Human Services. HHS enhances preparedness with new products to treat severe burns, September 30, 2015 [press release]. http://www.hhs.gov/about/news/2015/09/30/hhs-enhances-preparedness-new-products-treat-severe-burns.html. Accessed May 12, 2017.Google Scholar
10. Mauboussin, MJ, Callahan, D. Total Addressable Market: Methods to Estimate a Company’s Potential Sales. http://www.valuewalk.com/wp-content/uploads/2015/09/document-8067525701.pdf. Published September 1, 2015. Accessed May 12, 2017.Google Scholar
11. Berto, P, Masellis, A, Cherubino, M. Budget impact analysis of Nexobrid in the perspective of Italian hospitals (P052). Ann Burns Fire Disasters. 2015;28(suppl EBA). http://www.medbc.com/annals/review/vol_28/num_3b/text/vol28n3bp41.pdf.Google Scholar
12. European Medicines Agency. Assessment report NexoBrid. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Public_assessment_report/human/002246/WC500136582.pdf. Published September 20, 2012. Accessed May 12, 2017.Google Scholar
13. Rosenberg, L, Krieger, Y, Bogdanov-Berezovski, A, et al. A novel rapid and selective enzymatic debridement agent for burn wound management: a multi-center RCT. Burns. 2014;40(3):466-474. https://doi.org/10.1016/j.burns.2013.08.013.Google Scholar
14. American Burn Association. 2015 National Burn Repository: Report of data from 2005-2014. Dataset version 11.0. Chicago: American Burn Association; 2015.Google Scholar
15. Rosenberg, L, Shoham, Y, Krieger, Y, et al. Minimally invasive burn care: A review of seven clinical studies of rapid and selective debridement using a bromelain-based debriding enzyme (NexoBrid®). Ann Burns Fire Disasters. 2015;28(4). http://www.medbc.com/annals/review/vol_28/num_4/text/vol28n4p264.pdf.Google Scholar
16. Smith, MW, Friedman, B, Karaca, Z, Wong, HS. Predicting inpatient hospital payments in the United States: a retrospective analysis. BMC Health Serv Res. 2015;15(1):372. http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-1040-8. https://doi.org/10.1186/s12913-015-1040-8.Google Scholar
17. Healthcare Bluebook. https://healthcarebluebook.com/page_ProcedureDetails.aspx?id=14&dataset=MD. Accessed May 12, 2016.Google Scholar
18. Van den Bulte, C, Stremersch, S. Social contagion and income heterogeneity in new product diffusion. Marketing Sci. 2004;23(4):530-544. http://www.jstor.org/stable/30036687.Google Scholar
19. Bass, FM. A dynamic model of market share and sales behavior. In: Bass FM. Proceedings, Winter Conference. Chicago, IL, American Marketing Association; 1963:269-276.Google Scholar
20. Bass, FM. A new product growth model for consumer durables. Manage Sci. 1969;15(5):215-227. https://doi.org/10.1287/mnsc.15.5.215.Google Scholar
21. Bass, FM. Comments on “A New Product Growth for Model Consumer Durables The Bass Model.” Manage Sci. 2004;50(12 suppl):1833-1840.Google Scholar
22. Fruchter, GE, Van del Bulte, C. Why the generalized Bass Model leads to odd optimal advertising policies. Int J Res Market. 2011;28:218-230. http://www.biu.ac.il/soc/sb/papers/fruchter/Fruchter&VdB_IJRM2011.pdf.Google Scholar
23. Van den Bulte, C. Want to know how diffusion speed varies across countries and products? Try using a Bass model. Visions. http://www3.nd.edu/~busiforc/handouts/Other%20Articles/Bass%20model.pdf. Accessed May 12, 2017.Google Scholar
24. Dunn, AG, Braithwaite, J, Gallego, B, et al. Nation-scale adoption of new medicines by doctors: an application of the Bass diffusion model. BMC Health Services Res. 2012;12:248. https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-12-248.Google Scholar
25. OMB Circular A-94. Guidelines and Discount Rates for Benefit-Cost Analysis of Federal Programs. https://www.wbdg.org/FFC/FED/OMB/OMB-Circular-A94.pdf.Google Scholar
26. Philipson, TJ, Jena, AB. Endogenous cost-effectiveness analysis in health care technology adoption. NBER Working Paper 15032. https://www.aei.org/wp-content/uploads/2011/10/NBER%20Working%20Paper.pdf. Published June 2009. Accessed May 12, 2017.Google Scholar
27. Allgöwer, M, Schoenenberger, GA, Sparkes, BG. Pernicious effectors in burns. Burns. 2008;34S1: S1-S55. https://doi.org/10.1016/j.burns.2008.05.012.Google Scholar