The cost-effectiveness of a mechanical compression device in out of hospital cardiac arrest

Marti, Joachim, Hulme, Claire, Ferreira, Zenia, Nikolova, Silviya, Lall, Ranjit, Kaye, Charlotte, Smyth, Michael, Kelly, Charlotte, Quinn, Tom, Gates, Simon, Deakin, Charles D. and Perkins, Gavin D. (2017) The cost-effectiveness of a mechanical compression device in out of hospital cardiac arrest. Resuscitation, 117, pp. 1-7. ISSN (print) 0300-9572


AIM: To assess the cost-effectiveness of LUCAS-2, a mechanical device for cardiopulmonary resuscitation (CPR) as compared to manual chest compressions in adults with non-traumatic, out-of-hospital cardiac arrest. METHODS: We analysed patient-level data from a large, pragmatic, multi-centre trial linked to administrative secondary care data from the Hospital Episode Statistics (HES) to measure healthcare resource use, costs and outcomes in both arms. A within-trial analysis using quality adjusted life years derived from the EQ-5D-3L was conducted at 12-month follow-up and results were extrapolated to the lifetime horizon using a decision-analytic model. RESULTS: 4471 patients were enrolled in the trial (1652 assigned to the LUCAS-2 group, 2819 assigned to the control group). At 12 months, 89 (5%) patients survived in the LUCAS-2 group and 175 (6%) survived in the manual CPR group. In the vast majority of analyses conducted, both within-trial and by extrapolation of the results over a lifetime horizon, manual CPR dominates LUCAS-2. In other words, patients in the LUCAS-2 group had poorer health outcomes (i.e. lower QALYs) and incurred higher health and social care costs. CONCLUSION: Our study demonstrates that the use of the mechanical chest compression device LUCAS-2 represents poor value for money when compared to standard manual chest compression in out-of-hospital cardiac arrest.

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