Acute respiratory distress syndrome cost-effectiveness of therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Brian Shaller, M.D. [2]

Overview

Although ARDS is a serious medical condition associated with a very high mortality rate, the application of evidence-based therapies (e.g., lower tidal volume mechanical ventilation) have been shown to be cost-effective.

Cost-effectiveness of therapy

Although ICU-level care can be very costly, the use of low tidal volume mechanical ventilation appears to be cost-effective:

  • When the probability of surviving at least 2 months was > 70%, the cost per quality-adjusted life year (QALY) was $29,000
  • When the probability of surviving at least 2 months was 51 to 70%, the cost per QALY was $44,000
  • When the probability of surviving at least 2 months was < 50%, the cost per QALY was $110,000

References

  1. Hamel MB, Phillips RS, Davis RB, Teno J, Connors AF, Desbiens N; et al. (2000). "Outcomes and cost-effectiveness of ventilator support and aggressive care for patients with acute respiratory failure due to pneumonia or acute respiratory distress syndrome.". Am J Med. 109 (8): 614–20. PMID 11099680. 
  2. Cooke CR, Kahn JM, Watkins TR, Hudson LD, Rubenfeld GD (2009). "Cost-effectiveness of implementing low-tidal volume ventilation in patients with acute lung injury.". Chest. 136 (1): 79–88. PMC 2716714Freely accessible. PMID 19318673. doi:10.1378/chest.08-2123. 
  3. Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM; et al. (2009). "Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial.". Lancet. 374 (9698): 1351–63. PMID 19762075. doi:10.1016/S0140-6736(09)61069-2. 

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