Objectives: NexoBrid® is a non-surgical, enzymatic tool for selective burn wound debridement providing advantages vs. surgical standard of care (SOC). This empiric cost study compared treatment cost of NexoBrid®-based treatments and SOC, and analysed the cost impact of improved burn wound care using NexoBrid®.
Methods: The analysis is based on two different cost simulation models. Based on the results of a randomized phase III trial and costs specified in the G-DRG system, the Average Outcome Model (AOM) compares total costs of NexoBrid® based treatments vs. SOC to determine cost saving potentials. In the Defined Patient Model (DPM) distinct burn wound treatment pathways in clinical practice were assigned to actual treatment costs to allow economic considerations.
Results: Using NexoBrid® cost savings are inversely related to the treated TBSA (1-15%) and directly related to the savings in burn centre stay (up to 6.5 days) (AOM). Based on quantitative and qualitative aspects, three quarter ¾ of all cases in the range of 5% to -15% TBSA burned are in favour of NexoBrid®. Main cost drivers are LOS and ICU stay (45-80% of total costs). NexoBrid® becomes a more powerful cost driver with increasing TBSA treated. If NexoBrid® completely substitutes for SOC, total cost per patient can be reduced by nearly 30% (5% TBSA treated) or are in the range of SOC costs (15% TBSA treated) (DPM). 
Conclusion: Cost advantages using NexoBrid® emerge in cases with low or medium burned TBSA when costs for enzymatic debridement remain below SOC. Even in severe cases (15% TBSA burned) total costs of NexoBrid®-based pathways do not exceed costs of SOC pathways. Additionally, enzymatic debridement using NexoBrid® can be successfully applied as a strategic tool in order to reduce surgical procedure time and OR room capacity. Beside these quantitative aspects, qualitative improvements of burn wound care influencing overall economic efficiency must be considered.

Enzymatic burn wound debridement with NexoBrid®: Simulations of Total Treatment Costs and Comparison to SOC