OBJECTIVES : To evaluate the cost-effectiveness of propofol compared to midazolam in mechanically ventilated (MVd) critically ill adult patients.

PERSPECTIVE OF THE ANALYSIS Brazilian private health care system.

METHODS : A decision tree model was built to reflect the hospitalization of a MVd critically ill clinical patient. The time horizon was that of a ICU hospitalization, and the outcomes were cost effectiveness per hour of reduced ICU stay and cost effectiveness per hour of MV avoided. Data to populate the model came from a meta-analysis. The model was built based on the meta-analytic difference in the mean length of ICU stay and MV time. It was established that the cost of medication was embedded in the ICU cost, and that the daily ICU cost was the same in both arms. Univariate and probabilistic sensitivity analysis was performed.

RESULTS : Propofol use in MVd critically ill adult patients decreased ICU stay in 47.97 hours and 21.65 hours of MV. There was a cost reduction of R$ 4,397.25 when compared to midazolam. The cost-effectiveness per hour of ICU stay and MV time avoided was dominant in 94.70% and in 80.87% of the time, respectively.

CONCLUSIONS : Propofol may be the preferred choice for mechanically ventilated critically ill adult patients, reducing ICU stay and MV time.