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Applied Health Economics and Health Policy

Published in:

01-12-2005 | Original Research Article

The incremental cost effectiveness of withdrawing pulmonary artery catheters from routine use in critical care

Authors: Katherine Stevens, Christopher McCabe, Carys Jones, Joanne Ashcroft, Sheila Harvey, Kathy Rowan

Published in: Applied Health Economics and Health Policy | Issue 4/2005

Abstract

Objective

The objective of this study was to conduct an economic evaluation to identify any differences in the expected costs and outcomes between patients treated with pulmonary artery catheters (PACs) and those without, in order to better inform healthcare decision makers.

Method

The evaluation was carried out alongside a clinical trial investigating the use of PACs in intensive care units (ICUs) in the UK. It was conducted from the perspective of the UK NHS, in which PACs are an established intervention. Treating patients without using a PAC was characterised as the new intervention.

The primary outcome measure was QALYs. The secondary outcome measure was hospital mortality. NHS costs per patient were calculated for the financial year 2002/03.

The bootstrap method was used to characterise the uncertainty of the results and to construct cost-effectiveness acceptability curves.

Results

The cost per QALY and per life gained from the withdrawal of PACs were £2892 and £21 164, respectively.

Conclusion

The results of this study indicate that withdrawal of PACs from routine clinical use in ICUs within the NHS would be considered cost effective in the current decision-making climate.

¹Strictly there are other measures; however, the QALY is the most common.

²Conventional frequentist analysis often uses the confidence interval to characterise uncertainty. However, a 95% confidence interval does not tell you a range within which you are 95% certain the true value lies. Rather, it tells you that if you were to repeat the experiment 100 times and calculate the confidence interval on each occasion, in 95 of those analyses the true value would lie within the calculated range and on five occasions it would not. It provides no information about whether the results you are analysing are one of the 95 or one of the 5. In contrast to this, the Bayesian approach to characterising uncertainty, which is used in this study, tells you the degree of belief or probability that something is true.

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Title: The incremental cost effectiveness of withdrawing pulmonary artery catheters from routine use in critical care
Authors: Katherine Stevens
Christopher McCabe
Carys Jones
Joanne Ashcroft
Sheila Harvey
Kathy Rowan
Publication date: 01-12-2005
Publisher: Springer International Publishing
Published in: Applied Health Economics and Health Policy / Issue 4/2005
Print ISSN: 1175-5652
Electronic ISSN: 1179-1896
DOI: https://doi.org/10.2165/00148365-200504040-00008

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The incremental cost effectiveness of withdrawing pulmonary artery catheters from routine use in critical care

Abstract

Objective

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Method

Results

Conclusion

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Acknowledgement