Benefit-Cost Analysis of Moist Exposed Burn Ointment

Atiyeh BS, et al. Burns 2002; 28:659-663
 
The study has shown that patients not treated with MEBO application required statistically significant longer hospitalization.  It has shown also that the increased daily cost of MEBO® ointment, though statistically not significant, is largely offset by the 60% increase in cost of dressing and medical materials required by other topical therapy modalities which is extremely significant.  The combination of longer hospitalization and increased cost of conventional dressings clearly demonstrate the positive benefit of MEBOapplication in the topical treatment of minor to moderate second degree burns over conventional standard methods of local treatment whenever early surgical tangential excision and skin grafting is not feasible or warranted. 
 
The present study does not allow, however, extrapolation of these positive results to more extensive or deeper burns.  Moreover, the limitation of computation of cost of management to the period necessary for healing and re-epithelialization alone without considering the future cost of rehabilitation after actual wound healing and the cost of secondary corrective procedures may not give a realistic idea about the total actual cost of the local therapeutic modalities under study, particularly since different scar qualities may be expected.  Though scarring was not evaluated in the present study and its impact on the need of secondary corrective therapies with their obvious effect on total cost was not assessed, it has been previously shown that better scar quality may be expected following treatment of partial thickness wounds with MEBO.  This may mean that resultant scars following MEBO application may require less scar related treatment modalities and perhaps less secondary corrective procedures that by itself may make MEBO  application even more cost beneficial. 

Within the limits of the study, MEBO has been shown to be a cost beneficial alternative in the local management of minor to moderate second degree burns.  Benefit-cost analysis evaluating only the financial elements of a program is based on the assumption that the goal of a health care program is to save money.  This raises serious philosophical and ethical concerns.  The goals of health care must be to add years to life and life to years, in other words, to increase the quantity and quality of life that is practically impossible and even inappropriate to price tag.  From that particular perspective, the positive effects of MEBO expressed in terms of analgesia, psychological comfort, ease of application and better healing and scarring as demonstrated by previous studies adds tremendously to the benefit-cost analysis.