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

  • Farah Farahati (a1), Scott Nystrom (a2), David R. Howell (a2) and Richard Jaffe (a2)



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.


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.


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.


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)


Corresponding author

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:


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Drs Farahati and Nystrom contributed equally to this article.



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1. US Department of Health and Human Services. 2015 PHEMCE Strategy and Implementation Plan. Public Health Emergency website. Last updated January 3, 2017. Accessed May 12, 2017.
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.
3. US Department of Health and Human Services. Biomedical Advanced Research and Development Authority. Public Health Emergency website. Accessed May 12, 2017.
4. Jaffe, AB. The importance of “spillovers” in the policy mission of the advanced technology program. J Technol Transf. 1998;23(2):11-19.
5. Angelucci, M, Di Maro, V. Program Evaluation and Spillover Effects. Policy Research Working Paper no. WPS7243. Washington, DC: World Bank Group; 2015.
6. Herber, BP. Modern Public Finance. 5th ed. Homewood, IL: Richard D. Irwin; 1983.
7. Jones, CI, Williams, JC. Measuring the social return to R&D. Q J Econ. 1998;113(4):1119-1135.
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).
9. US Department of Health and Human Services. HHS enhances preparedness with new products to treat severe burns, September 30, 2015 [press release]. Accessed May 12, 2017.
10. Mauboussin, MJ, Callahan, D. Total Addressable Market: Methods to Estimate a Company’s Potential Sales. Published September 1, 2015. Accessed May 12, 2017.
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).
12. European Medicines Agency. Assessment report NexoBrid. Published September 20, 2012. Accessed May 12, 2017.
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.
14. American Burn Association. 2015 National Burn Repository: Report of data from 2005-2014. Dataset version 11.0. Chicago: American Burn Association; 2015.
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).
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.
17. Healthcare Bluebook. Accessed May 12, 2016.
18. Van den Bulte, C, Stremersch, S. Social contagion and income heterogeneity in new product diffusion. Marketing Sci. 2004;23(4):530-544.
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.
20. Bass, FM. A new product growth model for consumer durables. Manage Sci. 1969;15(5):215-227.
21. Bass, FM. Comments on “A New Product Growth for Model Consumer Durables The Bass Model.” Manage Sci. 2004;50(12 suppl):1833-1840.
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.
23. Van den Bulte, C. Want to know how diffusion speed varies across countries and products? Try using a Bass model. Visions. Accessed May 12, 2017.
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.
25. OMB Circular A-94. Guidelines and Discount Rates for Benefit-Cost Analysis of Federal Programs.
26. Philipson, TJ, Jena, AB. Endogenous cost-effectiveness analysis in health care technology adoption. NBER Working Paper 15032. Published June 2009. Accessed May 12, 2017.
27. Allgöwer, M, Schoenenberger, GA, Sparkes, BG. Pernicious effectors in burns. Burns. 2008;34S1: S1-S55.


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

  • Farah Farahati (a1), Scott Nystrom (a2), David R. Howell (a2) and Richard Jaffe (a2)


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