Cost-effectiveness of extracorporeal membrane oxygenation in resuscitation of patients with refractory cardiac arrest

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023884%3A_____%2F19%3A00008279" target="_blank" >RIV/00023884:_____/19:00008279 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/68407700:21460/19:00319414

Výsledek na webu

<a href="http://www.ekonomie-management.cz/en/archiv/search/detail/1600-cost-effectiveness-of-extracorporeal-membrane-oxygenation-in-resuscitation-of-patients-with-refractory-cardiac-arrest/" target="_blank" >http://www.ekonomie-management.cz/en/archiv/search/detail/1600-cost-effectiveness-of-extracorporeal-membrane-oxygenation-in-resuscitation-of-patients-with-refractory-cardiac-arrest/</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.15240/tul/001/2019-2-011" target="_blank" >10.15240/tul/001/2019-2-011</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Cost-effectiveness of extracorporeal membrane oxygenation in resuscitation of patients with refractory cardiac arrest

Popis výsledku v původním jazyce

Extracorporeal cardiopulmonary resuscitation (ECPR) has been recently introduced as a therapeutic option for refractory cardiac arrest. Despite growing evidence demonstrating improved survival rate, a number of questions remains unanswered and data on cost-effectiveness are still insufficient. The paper is based on a retrospective observational comparative study of authentic clinical data from patient records. Incremental cost-effectiveness and cost-utility analyses were performed from health care provider's perspective. Sixteen patients undergoing ECPR were included into the analysis and their data were compared with 35 subjects with conventional CPR for refractory cardiac arrest. In the ECPR group eight out of sixteen patients were weaned from ECMO, four of them with good neurological outcomes (CPC 1-2); three patients survived one year with CPC 1-2, one patient survived one year with severe neurological dysfunction (CPC 3), and one patient with persisting coma (CPC 4). In comparison, in the non-ECPR group all patients died within 24 hours. In the ECPR group, the average annual costs per patient reached CZK 885,044 (Levitronix Centrimag), and CZK 788,432 (Cardiohelp) (the 2013 price level). CUA revealed 3,961,970 CZK/QALY with Cardiohelp, and 4,447,457 CZK/QALY with Levitronix. However, if only patients with CPC 1-2 were included into the analysis, the cost-utility ratio decreased below the unofficial Czech cost-effectiveness threshold. Our data indicate that ECPR for refractory cardiac arrest may be cost-effective despite high costs per individual patients, especially if we were able to better select patients for this intervention based on a reliable prediction of the neurological outcome.

Název v anglickém jazyce

Cost-effectiveness of extracorporeal membrane oxygenation in resuscitation of patients with refractory cardiac arrest

Popis výsledku anglicky

Extracorporeal cardiopulmonary resuscitation (ECPR) has been recently introduced as a therapeutic option for refractory cardiac arrest. Despite growing evidence demonstrating improved survival rate, a number of questions remains unanswered and data on cost-effectiveness are still insufficient. The paper is based on a retrospective observational comparative study of authentic clinical data from patient records. Incremental cost-effectiveness and cost-utility analyses were performed from health care provider's perspective. Sixteen patients undergoing ECPR were included into the analysis and their data were compared with 35 subjects with conventional CPR for refractory cardiac arrest. In the ECPR group eight out of sixteen patients were weaned from ECMO, four of them with good neurological outcomes (CPC 1-2); three patients survived one year with CPC 1-2, one patient survived one year with severe neurological dysfunction (CPC 3), and one patient with persisting coma (CPC 4). In comparison, in the non-ECPR group all patients died within 24 hours. In the ECPR group, the average annual costs per patient reached CZK 885,044 (Levitronix Centrimag), and CZK 788,432 (Cardiohelp) (the 2013 price level). CUA revealed 3,961,970 CZK/QALY with Cardiohelp, and 4,447,457 CZK/QALY with Levitronix. However, if only patients with CPC 1-2 were included into the analysis, the cost-utility ratio decreased below the unofficial Czech cost-effectiveness threshold. Our data indicate that ECPR for refractory cardiac arrest may be cost-effective despite high costs per individual patients, especially if we were able to better select patients for this intervention based on a reliable prediction of the neurological outcome.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2019

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

E & M Ekonomie a Management

ISSN

1212-3609

e-ISSN

—

Svazek periodika

22

Číslo periodika v rámci svazku

2

Stát vydavatele periodika

CZ - Česká republika

Počet stran výsledku

12

Strana od-do

161-172

Kód UT WoS článku

000482727500011

EID výsledku v databázi Scopus

2-s2.0-85070016386