A Study of Pre-hospital ECPR Cost Effectiveness in New South Wales
- Oct 2
- 1 min read
This study explored whether providing a very advanced type of life support called pre-hospital extracorporeal cardiopulmonary resuscitation (PH-ECPR) is a good investment for people who suffer from an out of hospital cardiac arrest.
PH-ECPR uses a portable machine to take over the heart and lungs during CPR. It can be initiated and maintained by a multi-disciplinary medical team before reaching the hospital. For rural and remote communities in British Columbia, where long distances to tertiary hospitals can limit access to advanced care, PH-ECPR could be, at least theoretically, very valuable.
This research, based on real-world data from Australia, found that PH-ECPR can significantly increase the number of people who survive cardiac arrest with good quality of life. The cost per patient is about $88,000 (AUD), or roughly $44,000 per quality-adjusted life year (QALY). These numbers are certainly within the range considered cost-effective in Canada - though direct comparisons are difficult. It is also important to note that this is much lower than for many novel cancer drugs for example.
Importantly, the study showed that PH-ECPR is most efficient when the interprofessional (doctor and paramedic) mobile team also responds to other emergencies. Thus, making the service more sustainable for large geographical areas if its role includes other critical care functions. For British Columbia’s rural regions, PH-ECPR could help bridge the gap in emergency care, saving more lives, even in remote settings. At the very least, we should be talking about it.
