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


METHODS
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 Pounds 2892 and Pounds 21,164, respectively.


CONCLUSIONS
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.
Stevens
Katherine
K
School of Health and Related Research (ScHARR), Health Economics and Decision Science, University of Sheffield, Sheffield, England. K.Stevens@Sheffield.ac.uk
McCabe
Christopher
C
Jones
Carys
C
Ashcroft
Joanne
J
Harvey
Sheila
S
Rowan
Kathy
K
D000368:Aged; D002407:Catheterization, Swan-Ganz / Q000191:economics* / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis / Q000379:methods*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006779:Hospitals, Public / Q000191:economics; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D017063:Outcome Assessment, Health Care / Q000191:economics* / Q000379:methods; D010351:Patient Discharge; D019057:Quality-Adjusted Life Years; D018570:Risk Assessment; D013222:State Medicine / Q000191:economics; D006113:United Kingdom; D028761:Withholding Treatment / Q000191:economics*