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Artigo Acesso aberto Produção Nacional Revisado por pares
BIBTEX RIS

POSC102 High-Flow Nasal Cannula in Patients with COVID-19: Is a Cost-Effective Alternative?

2022; Elsevier BV; Volume: 25; Issue: 1 Linguagem: Inglês

10.1016/j.jval.2021.11.507

ISSN

1524-4733

Autores

J.M. Alves, Danilo Villagelin, FE Prota, A. Chrispim, C Silva, Eriko Yamanaka, R. Tagliolatto, J. Beraldo, Henk de Kater, Joana Gomes, Sindélia Freitas, Raquel Camargos Borges, Ary Augusto de Castro MACEDO,

Tópico(s)

Tracheal and airway disorders

Resumo

To determine whether the high-flow nasal cannula (HFNC) is a more cost-effective alternative when compared to conventional oxygen therapy (COT) for decreasing invasive ventilation rates in the treatment of acute hypoxemic respiratory failure (HRF) in patients with Covid- 19 from the perspective of private health. The cost-effectiveness analysis (ACE) was developed through the "decision tree" model. The cost factor was calculated by the average daily ICU value for both procedures, with the unit value of the HFNC being added. The effectiveness factor, due to the absence of real-life data, was obtained by conducting a systematic review with meta-analysis, limited to HRF. After calculating costs inherent to the procedures, we have: HFNC = US$664.75 and COT = US$465.71; corresponding to an increase of US$199.04 for HFNC. As for effectiveness, the systematic review and meta-analysis developed included 1859 patients (HFNC: 781 and COT: 1078). The event rate, that is, of patients who progressed to invasive ventilation, was 35% (272) for the HFNC group and 39% (421) for the COT group - with no statistically significant difference (Risk Difference [RD] -0.03, 95% CI -0.08 to 0.01; p = 0.62 - NNT = ns). In possession of the cost and effectiveness factors, ACE demonstrates that COT is more cost-effective: US$1,019.98 vs. US$764.12; showing an increase of US$255.86 per daily ICU with HFNC. Considering that the medical literature does not show a statistically significant difference in the rates of patients who progress to invasive ventilation, the development of ACE is fundamental to support decision making. When considering an average of 10 days in the ICU, the savings sustained by the adoption of COT alone is US$2,558.60 per patient.

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