
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Acute respiratory distress syndrome cost-effectiveness of therapy
Introduction
Overview
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
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:
- One study of patients with respiratory failure due to pneumonia or ARDS concluded that mechanical ventilation was cost-effective when the probability of surviving at least 2 months following mechanical ventilation was > 50%:[1]
- 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
- One study of patients with acute lung injury (ALI) concluded that the implementation of low tidal volume mechanical ventilation (lung protective ventilation) was more cost-effective compared to other, non-lung-protective mechanical ventilation strategies, with an increase in quality-adjusted life years (QALYs) of 15% at an additional cost of $7,233 per patient treated with lung-protective ventilation.[2]
- The CESAR trial compared conventional mechanical ventilation practices to extracorporeal membrane oxygenation (ECMO) in patients with severe ARDS and calculated a QALY gain of 0.03 at a cost of £19,252 (roughly $31,000 in the year when the study was published).[3]
References
References
- ↑ 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.
- ↑ 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. doi:10.1378/chest.08-2123. PMC 2716714. PMID 19318673.
- ↑ 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. doi:10.1016/S0140-6736(09)61069-2. PMID 19762075.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Brian Shaller, M.D. [2]
