ECONOMIC EVALUATION OF DEXMEDETOMIDINE VERSUS PROPOFOL OR MIDAZOLAM SEDATION IN MECHANICAL VENTILATED ICU PATIENTS IN SPAIN
Author(s)
Rubio-Terrés C1, Jimenez JJ2, Romera Ma3, Campo C4, Rubio-Rodríguez D1, Turunen H5
1Health Value, Madrid, Spain, 2Hospital La Laguna, Tenerife, Spain, 3Hospital Puerta de Hierro, Madrid, Spain, 4Orion Pharma, Madrid, Spain, 5Orion Corporation Orion Pharma, Espoo, Finland
OBJECTIVES: To evaluate costs associated with the use of dexmedetomidine in comparison with standard care sedation (propofol or midazolam) in Spain in intensive care unit (ICU) patients through a cost-minimisation and a budget impact analyses. METHODS: The population consisted of ICU ventilated patients requiring a mild to moderate level of sedation. Time spent at ICU was estimated based on two head-to-head published clinical trials (PRODEX, MIDEX) comparing the two sedative strategies. The time horizon was inpatient stay at ICU considering three periods: mechanical ventilation, non-mechanical ventilation and off ventilator. The analysis considered the Spanish National Health System (NHS) perspective and only included ICU stay and sedative costs, which were obtained from Spanish sources (2017 prices). We adapted a previously built model, which was based on published data: average body weight 72.0 kg, current 24h cost of dexmedetomidine (1 amp 2 ml: €18), midazolam (10 amp 1 ml: €1.60), propofol (1 vial 100 ml: €6.90) and 1 day ICU stay cost (€1,497.85). RESULTS: The estimated mean costs per ICU patient discharge were € 18,653 with standard care and € 18,236 with dexmedetomidine. Savings per patient treated were € 417 (€655 versus midazolam and €180 versus propofol). A 30% change of sedated patients at ICU from standard care (50% midazolam, 50% propofol) to dexmedetomidine in a cohort of 1000 patients/year would result in yearly savings of at least € 417,220 for the Spanish NHS and 294 ICU free days (that allow to treat 62 additional patients/year). CONCLUSIONS: Dexmedetomidine reduces the duration of mechanical ventilation and is a cost-saving alternative to propofol and midazolam at the ICU setting in Spain.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PSY34
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Systemic Disorders/Conditions