| Project Title:
Economic Analysis of Pulmonary Artery Catheter Use
Funding Agency:
NIH/Agency for Healthcare Research
Total Project Period:
Sep 30, 2001 - Aug 30, 2006
Principal Investigator:
Derek Angus, MD
Co-Investigator(s):
Darryl T Gray, Paula Deihr, Gordon Rubenfeld, Tari Topolski, Louise Novak,
Judith Lave, Lisa Weissfeld, Mark Roberts
Project Summary:
The pulmonary artery catheter (PAC) is a commonly used device that provides hemodynamic data to guide care of the critically ill, such as patients with acute respiratory distress syndrome or acute lung injury (ARDS/ALI). Clinicians believe PAC use improves decision-making and patient outcomes but evidence is lacking and recent data suggest the PAC may increase mortality as well as considerably increase costs. In response, the NHLBI funded a large multi-center trial (Fluid And Catheter Treatment Trial (FACTT)), in which ARDS/ALI patients will be randomized to receive a PAC or the less invasive central venous catheter (CVC) and to receive a liberal or conservative fluid management protocol in response to data provided by the PAC or CVC. The primary end-point of FACTT will be in-patient mortality.
We are complementing FACTT with a concurrent economic analysis of the PAC. Our aims are to: 1.) Compare differences between study arms in long-term survival, quality of life, and quality-adjusted survival; 2.) Compare differences between study arms in acute care and long-term costs; 3.) Calculate the cost-efficacy of PAC use (i.e., the balance of costs and effects under the controlled environment of the FACTT trial), and 4.) Estimate cost-effectiveness under more “real-world” conditions and produce life-time cost-effectiveness ratios, thereby facilitating comparison of our results to other cost-effectiveness analyses. The results of our proposed adjunct to FACTT will substantially amplify the value of the data being collected and provide, for the first time, robust estimates from randomized data of the economic effects of the widespread application of this important technology.
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