OBJECTIVES: . The purpose is to evaluate the cost-effectiveness of the parenteral use of N-acetylcysteine (NAC) in the treatment of Acute Respiratory Distress Syndrome (ARDS) in adults who contracted COVID-19 infection.

METHODS: . A cost-effectiveness analysis is developed through the design of a decision tree model that simulates the care of patients with ARDS admitted to the ICU, evaluating the addition of parenteral NAC within the comprehensive treatment, considering that clinical evidence shows its ability to modify the course of the disease, reducing the stay in the ICU. The outcome is the number of days at ICU stay associated with ARDS and COVID-19. A series of sensitivity analyzes are proposed in such a way that the uncertainty and robustness of the model and its results can be evaluated.

RESULTS: . For two evaluated scenarios of ARDS with bacterial, viral or nonspecific pneumonia and ARDS with viral type pneumonia: the cost of comprehensive care / comprehensive care + NAC is $26,513,091 / $22,496,076 and $25,618,385 / $21,714,198 colombian pesos respectively. And the number of days in ICU are respectively 8.38 / 6.84 and 8.08 / 6.59. The foregoing shows that the strategy that includes NAC is dominant in the two scenarios and therefore is the preferred option. The sensitivity analyzes showed that the robustness of the results remains under changes in the parameters, giving confidence that the findings are consistent in different scenarios.

CONCLUSIONS: . The administration of parenteral NAC during the first five days of ARDS reduces the hospital stay in the ICU when compared to just comprehensive care. The technology used has favorable impact on the budget, since it reduces the associated healthcare costs.