Trial reportEuropean heart journal. Acute cardiovascular care2026
Cost-effectiveness of extracorporeal CPR for out-of-hospital cardiac arrest: a trial-based Markov model with a lifetime horizon.
Trial report in European heart journal. Acute cardiovascular care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
21 authors.
Funding
Abstract
aimsExtracorporeal cardiopulmonary resuscitation (ECPR) can restore circulation in refractory out-of-hospital cardiac arrest (OHCA). A trial-based analysis with a 1-year horizon showed limited cost-effectiveness of this demanding procedure. However, arguably, long-term incremental health benefits may justify high initial incremental costs. We assessed the cost-effectiveness of ECPR compared with conventional cardiopulmonary resuscitation (CCPR) for OHCA with a lifetime horizon using trial-based data.
methodsHealthcare and societal costs and quality adjusted life years (QALY), assessed using EQ-5D-5L, were simulated over a 20-year period following ECPR or CCPR for OHCA using a Markov model. Data from the per-protocol population of a multicentre randomized controlled trial comparing ECPR with CCPR were used as input parameters. The incremental cost-effectiveness ratio (ICER) was expressed as Euros per QALY. Probabilistic and deterministic sensitivity analyses were performed.
resultsWe used data from 33 ECPR and 47 CCPR patients. Mean ± SD costs after 1 year were €26.372 ± 28.237 vs. €10.356 ± 37.706, and survival was 15% vs. 9% in patients treated with ECPR vs. CCPR. Over a lifetime horizon, mean incremental costs and QALYs of ECPR were €160.969 and 0.66, respectively, resulting in an ICER of €242.122/QALY. At a willingness-to-pay threshold of €80.000 per QALY gained, the probability of ECPR being cost-effective was 46%. The costs of non-survivors in both arms and the QALYs gained were the major drivers of the ICER.
conclusionExtracorporeal cardiopulmonary resuscitation for refractory OHCA has a low probability of being cost-effective. To enhance cost-effectiveness, improving ECPR effectiveness and reducing hospital costs of ECPR non-survivors are mandatory.
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