title: Economic evaluation of propofol for sedation of patients admitted to intensive care units.
abstract: BACKGROUND
  The goal of the current study was to evaluate the economic impact of propofol as compared with midazolam for sedating patients in the intensive care unit (ICU).
  
  
  METHODS
  A randomized, unblinded, multicenter pharmacoeconomic trial captured health resource utilization and outcome measurements associated with sedation and treatment of patients in four ICUs across Canada. Statistical analysis was performed to investigate the difference in sedation quality, ICU length of stay, and other health resources used. The authors compared the costs (1997 Canadian dollars) associated with the two treatments. Two types of sensitivity analyses were performed.
  
  
  RESULTS
  Although overall sedation duration was similar, propofol patients spent more time at adequately sedated status (60.2% vs. 44%; P = 0.01) and were extubated faster (median extubation time, 2.5 vs. 7.1 h; P = 0.001). The ICU length of stay and health resource utilization did not differ. The total cost per patient, including drug cost and ICU stay cost, did not differ between groups (median, $5,718 for propofol vs. $5,950 for midazolam; P = 0.94). The first sensitivity analysis suggested that the incremental cost (per patient) of propofol varies from an extra cost of $114 to a savings of $2,709. Based on a hypothetical model, the second sensitivity analysis showed a potential saving of $479 per patient as a result of improved discharge planning.
  
  
  CONCLUSIONS
  The analysis demonstrated that using propofol resulted in a reduction of time to extubation and higher sedative regimen costs. There was no difference in intensity of resource use or ICU length of stay and hence in costs. Issues regarding discharge delay among propofol-treated patients remain to be explored.
authors.affiliation: Department of Health Care and Epidemiology, University of British Columbia, Canada. anis@cheos.ubc.ca
authors.forename: Aslam H
authors.initials: AH
authors.lastname: Anis
authors.forename: Xiao-hua
authors.initials: XH
authors.lastname: Wang
authors.forename: Hector
authors.initials: H
authors.lastname: Leon
authors.forename: Richard
authors.initials: R
authors.lastname: Hall
mesh_terms: D016527:Drug Costs; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D007362:Intensive Care Units / Q000191:economics; D007902:Length of Stay; D008874:Midazolam / Q000494:pharmacology; D015742:Propofol / Q000191:economics / Q000494:pharmacology*
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam; D015742:Propofol