Cost-effectiveness analysis high flow oxygen therapy in the treatment of SARS-CoV-2 pneumonia

Introduction: high-oxygen nasal cannulas in patients with respiratory failure secondary to SARS-CoV-2 pneumonia have not been studied from a cost-effectiveness point of view.Methods: Retrospective analysis of patients who had entered the COVID-area of an intensive medicine service in a third reference hospital, between March-December 2020. An effective-ness cost analysis was carried out comparing 2 therapeutic decisions: the experimental strategy was defined as a mixed strategy consisting of the initial application of high flow nasal oxygen (HFNO) and application of VMI only to HFNO failures. The optimal rational decision was defi-ned as maximizing expected profit, and economic efficiency was assessed by calculating the Incremental Cost-Effectiveness Ratio (ICER) for years of life gained.Results: Of the 185 patients tested, 101 (55%) received invasive mechanical ventilation imme-diately and 84 (45%) were treated with HFNO at the outset. In the cost-effectiveness analysis, comparing both therapeutic strategies, the probability that the experimental strategy would be more effective was 0.974, reaching statistical significance: Difference in average proportions-0.113; 95% CI:-0.018 to-0.208. This corresponds to an NNT of 9 patients. The optimal decision was HFNO's strategy followed by VMI in HFNO failures. This option had an RCEI of 5582 euros per year of life gained.Conclusions: It is important to establish in the future reliable markers in the use of HFNO so that this therapy improves its cost-effective benefits.& COPY; 2022 FECA. Published by Elsevier Espan & SIM;a, S.L.U. All rights reserved.