OBJECTIVES:

Targeted temperature management (TTM) has been shown to improve neurologic outcomes and survival for patients with return of spontaneous circulation from out-of-hospital cardiac arrest (ROSC-OHCA). This study aims to evaluate the cost-effectiveness of a non-invasive TTM with a feedback system (Product: Arctic Sun^TM) for ROSC-OHCA patients in China.

METHODS:

A cost-effective analysis model was developed to compare TTM with feedback system against conventional cooling methods from society perspective, over short-term (1 year) and long-term (CPC1-2: 12.5 years, CPC3-4: 8 years) scenarios. Efficacy data were obtained from available literature and local A&E expert survey. Health utility data were abstracted from previous publications. Cost data were collected from the medical service price of each province and the expert survey. One-way and probabilistic sensitivity analysis (PSA) were conducted to assess the robustness of the model.

RESULTS:

Base case results suggested that: For the short-term scenario, the TTM with feedback system added 0.089 quality-adjusted life year (QALY) compared against conventional methods, yielded an incremental cost-effectiveness ratio (ICER) of $32,339/QALYs, which was less than three times gross domestic product (GDP) per capita of China in 2021 ($35,832/QALY), indicating that it is cost-effective. Under the long-term scenario, TTM is a dominant strategy by cost-saving of $2,032 and gaining effectiveness with 0.979 QALY, compared with conventional methods. The results of one-way sensitivity showed that the proportion of CPC2 of TTM and the proportion of CPC2 and CPC1 of the conventional methods had the largest impact on the ICER in both scenarios. PSA estimated 60.16% of TTM to be cost-effective in the short-term scenario, while it would be 100.00% dominant in the long-term scenario, indicating the robustness of the results.

CONCLUSIONS:

The non-invasive targeted temperature management therapy with feedback system provides better neurologic outcomes for ROSC-OHCA patients and is a cost-effective and potentially cost-dominant treatment in China.