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Cost-effectiveness of neonatal extracorporeal membrane oxygenation based on 7-year results from the United Kingdom Collaborative ECMO Trial
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Petrou, Stavros, Bischof, Matthias , Bennett, Charlotte , Elbourne, Diana , Field, David and McNally, Helena (2006) Cost-effectiveness of neonatal extracorporeal membrane oxygenation based on 7-year results from the United Kingdom Collaborative ECMO Trial. Pediatrics, 117 (5). pp. 1640-1649. doi:10.1542/peds.2005-1150 ISSN 0031-4005.
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Official URL: http://dx.doi.org/10.1542/peds.2005-1150
Abstract
OBJECTIVE. To assess the long-term cost-effectiveness of extracorporeal membrane oxygenation (ECMO) for mature newborn infants with severe respiratory failure.
METHODS. A prospective economic evaluation was conducted alongside a pragmatic randomized, controlled trial in which 185 infants were randomly allocated to ECMO (n = 93) or conventional management (n = 92) and then followed up to 7 years of age. Information about their use of health services during the follow-up period was combined with unit costs (£, 2002–2003 prices) to obtain a net cost per child. The cost-effectiveness of neonatal ECMO was expressed in terms of incremental cost per additional life year gained and incremental cost per additional disability-free life year gained. The nonparametric bootstrap method was used to present cost-effectiveness acceptability curves and net benefit statistics at alternative willingness-to-pay thresholds held by decision-makers for an additional life year and for an additional disability-free life year.
RESULTS. Over 7 years, neonatal ECMO was effective at reducing known death or severe disability. Mean health service costs during the first 7 years of life were £30270 in the ECMO group and £10229 in the conventional management group, generating a mean cost difference of £20041 that was statistically significant. The incremental cost per life year gained was estimated at £13385. The incremental cost per disability-free life year gained was estimated at £23566. At the notional willingness-to-pay threshold of £30000 for an additional life year, the probability that neonatal ECMO is cost-effective at 7 years was estimated at 0.98. This translated into a mean net benefit of £24362 for each adoption of neonatal ECMO rather than conventional management.
CONCLUSIONS. This study provides rigorous evidence of the cost-effectiveness of neonatal ECMO during childhood.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Pediatrics | ||||
Publisher: | American Academy of Pediatrics | ||||
ISSN: | 0031-4005 | ||||
Official Date: | 2006 | ||||
Dates: |
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Volume: | 117 | ||||
Number: | 5 | ||||
Page Range: | pp. 1640-1649 | ||||
DOI: | 10.1542/peds.2005-1150 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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